Affecting Factors on nurses outflows in Iran 2018: a systematic review

Background: Nurses are the highest professional workforce at a hospital, and they have become a critical factor in improving productivity and competitiveness of hospitals. In the healthcare industry, the attrition rate of nurses has been the highest among all employee categories. Aim: The purpose of this study was to investigate the factors affecting nurses' outflow from Iran's health system. Methods: We conducted a systematic search in the web of science, PubMed, OVID, SID, Magiran and google scholar in 2016. The selected period for searching articles was from 2000 to 2016. Results: Tendency of Iranian nurses to leave services was correlated with justice, commitment, individual factors, organizational factors, cultural, economic and social factors. The individual factors include the type of health sector, level of income, job satisfaction, work and family conflict. The organizational factors include organizational atmosphere, work issues, job stress, work exhaustion, working life quality, and ethical leadership. Conclusion: Targeting interventions to enhance participation in hospital affairs, adequacy of staffing and resources and enabling and supporting behaviors and creating opportunities for growth and professional development could be beneficial for a stable nursing workforce. The challenge for nurse leaders is to use the evidence generated from this study and previous studies to develop professional practice environments that facilitate the cultural changes needed to build and sustain a quality nursing workforce. It seems essential that hospital managers consider these factors in their planning and decision makings