الفهرس 
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Abstract
Nursing is a sensitive career that plays an important role in society.
Nurses are the main persons responsible about a patient life or the patient
at risk for suffering. Motivated nurses work under conditions that
promote retention and thwart turnover tend to produce outcomes that are
satisfactory. Thus the hospitals have to understand the factors affecting
nurses’ motivation and retention in their work to empower all personnel to
be more and more productive and increase quality of patient care and
reduce turnover rate.
The study was conducted to assess the relationship between
motivating work factors and nurses’ retention at Menoufia University
Hospital and Shebin El-Kom Teaching Hospital. This was achieved
through assessing the motivating work factors among nurses, assessing
the factors affecting nurses’ retention and determining the relationship
between motivating work factors & nurses’ retention at the study settings.
Research design:
A descriptive correlational research design was used in conducting
this study.
Setting:
This study was conducted at selected departments in two different
hospitals in Shebin El-Kom, Menoufia Governorate, namely: Menoufia
University Hospital and Shebin El-Kom teaching hospital.
The study settings were divided into three categories which include the
following:
•Critical care departments which include the following:
Emergency, O.R, adult ICU, pediatric ICU, neonate, Burn, &
Hemodialysis department.
•Inpatient departments which include the following: medical,
surgical, pediatrics, obstetrics & Gynecology, neurological,
cardiology, chest, Orthopedics, & Oncology departments.
•Nursing administration department.
Subjects:
The subjects of this study included : A convenient sample of 315
nurses were recruited from Menoufia University hospital (159) and
Shebin El-Kom Teaching hospital (156). The inclusion criteria: They
have at least two years of experience working in the hospital and accepted
to participate in the study.
Tools of data collection:
Two tools were utilized by the investigator to collect data. These tools
were:
1. Motivational Level Questionnaire was used to assess the
motivating work factors among nurses at Menoufia University
hospital and Shebin El-Kom teaching hospital. The questionnaire
consisted of three parts which included first part to assess sociodemographic
data, second part to assess ranking of desired
motivating work factors according to their importance and third
part to assess the extent to which hospitals provide motivating
work factors.
Summary
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2. Nurses’ Retention Questionnaire was used to assess factors
leading to nurses’ retention at Menoufia University Hospital and
Shebin El-Kom Teaching Hospital. The questionnaire consisted of
three parts which included first part to assess contributing factors
of retention, second part to assess ranking of contributing factors of
turnover and third part to assess the level of intention to leave
hospitals.
These tools were tested for reliability by the internal consistency
coefficient alpha that was (0.96 & 0.97 respectively).
Pilot study:-
A pilot study was carried out before starting the actual data
collection. The purpose of the pilot study was to ascertain clarity,
relevance, applicability of the study tools and to determine obstacles that
may be encountered during data collection. It also helped to estimate the
time needed to fill the questionnaire tools. The pilot study was carried on
32 nurses which presented (10%) of sample size and excluded from the
main study sample to fill out the questionnaire.
Field work:
Data was collected upon four months started from 10th of March
2016 to 10th of July 2016. It was collected in the morning, afternoon, and
night shifts and subjects fill in the questionnaire in the presence of the
investigator to ascertain all questions were answered. The time required
for each nurse to fill the questionnaire was estimated to be 15-20 minutes.
Statistical methodology:
The data collected was tabulated and analyzed by SPSS (statistical
package for social science) version 18 on IBM compatible computer.
Results:
The main findings of the present study revealed the following:
•There was a very highly statistical significant positive correlation
between total motivating work factors and total retention factors.
•The desired motivating work factors ranked as the top five factors
were: recognition and appreciation, salary, rewards, advancement
and growth, training and development.
•There was no difference in ranking of the 1st motivating work
factor in both hospitals (Teaching Hospital &University Hospital)
by the studied subjects which were recognition and appreciation,
and salary.
•The actual provided motivating work factors by the studied settings
were arranged as the following: job characteristics, working
conditions, feedback, training and development, job responsibility,
leadership, goal-setting, job security, rewards, salary, advancement
and growth, recognition and appreciation, & performance
appraisal.
•The majority of the studied subjects at both hospitals (Teaching
Hospital & University Hospital) were moderately motivated
(55.80% & 57.62% respectively).
•Moreover, total retention factors at University Hospital and
Teaching Hospital were moderate (41.32%& 39.97% respectively).
•The majority of studied subjects reported that the 1st three
categories (salary and incentives, job contents, work environment)
of contributing factors of retention were provided by the study
settings at semi-equal percentage (40.73%, 41.1%, and 41.02%
respectively). While organizational factors were provided at the
lowest percentage (36%).
•The potential contributing factors of turnover as reported by the
studied subjects ranked as the top five factors were: work overload,
bad working relation with nursing supervisors, scheduling system,
unsatisfactory salary, and tenure problems.
•There was no difference in ranking of the 1st potential contributing
factors of turnover in both hospitals (Teaching Hospital
&University Hospital) by the studied subjects.
•Most of the studied subjects (61.9%) had intention to leave
hospitals. Also, there was no statistically significant difference
between the two hospitals regarding intention to leave.
•The studied subjects had intention to remain in hospitals in spite of
the moderately motivated nursing staff and moderate retention
factors provided by the study settings.
•The highest percentage of the studied subjects’ age is less than
35years (37.1%). This finding indicated that nurses are mostly
young, accordingly they will have long year to work.
•The studied subjects’ more than or equal 45 years are motivated
(65.56%) and retained (45.98%) compared to other age groups of
the studied nurses.
•There were statistical significant differences between age and total
motivating work factors and total retention factors as P-value <.05.
Recommendations:
Based on the findings of this study and the review of the literature, the
following recommendations are proposed:
At practical level:
•Disseminate the study results to the important key persons (hospital
administrators) to be considered when dealing with nurses to
decrease the liability of de-motivation and increase the retention
rate of nurses at hospitals.
•Recognition and appreciation of the good work done by staff
nurses is the key issue that should be tackled seriously by health
managers in hospitals. Staff will appreciate basic motivation
schemes such as nurse of the month award.
•Improve the compensation system of basic salary, incentives and
bonuses that are competitive.
•Update the hospital policies related to nursing vacations, nursing
work hours, and inventory to aid in retention of nurses.
•Provide an adequate number of nurses and ensure an appropriate
distribution of the current nursing workforce to reduce work load
and keep nurses retained in their work.
•The job description should be reviewed and updated to reduce
workloads and any non-nursing duties, which in turn reduce
turnover and improve retention rate of nurses.
•Nursing assistants and other supportive staffs should be recruited in
accordance with the number of the patients.
•Provide 24-hours nursery for the children of nurses during work
shifts to provide motivating work climate and aid in retention of
nurses.
•Holding workshops with staff to discuss the strategies to motivate
and retain nurses.
At educational level:
•Provide nurse managers/supervisors with training programs in the
art of management, leadership and communication skills.
•Provide newly employed nurses with well-prepared orientation
program which aid in retaining nurses.
•Opportunities to attend national and international nursing
conferences should be organized for staff to update their
knowledge in contemporary medical practice.
•Nurses should be included in hospital committees to facilitate
professional development through the expansion of their
knowledge and sharing in decision making.
•Management of hospitals should conduct annual assessment of the
motivation and retention level of nurses and take proactive actions
to decrease turnover of nurses.
At research level:
•Replication of the study on large sample size and different settings.
•Further research is also needed to assess the impact of retention
strategies on quality of patient care.