Contents lists available at ScienceDirect Applied Nursing Research journal homepage: www.elsevier.com/locate/apnr Factors influencing turnover intention among registered nurses in Samar Philippines Leodoro J. Labrague a, ⁎ , Donna S. Gloe b , Denise M. McEnroe-Petitte c , Konstantinos Tsaras d , Paolo C. Colet e a Sultan Qaboos University, Muscat, Oman b Southwest Baptist University, USA c Kent State University, USA d Technological Institute of Thessaly, Greece e Shaqra University, Saudi Arabia ARTICLE INFO Keywords: Work satisfaction Work stress Turnover intention Philippine nurses ABSTRACT Objective: Despite the massive nurse migration and turnover of nurses in the Philippines, there remains a lack of studies describing factors influencing the migration of Filipino nurses. This study explored the effects of nurses' characteristics, work satisfaction, and work stress with the intent to leave an organization among registered nurses in the Philippines. Methods: This study utilized a descriptive, cross-sectional approach. One hundred sixty six (166) nurses parti- cipated in the study during the months of September 2015 to December 2015. Three standardized instruments were used in the study: Job Satisfaction Index (JSI), Job Stress Scale (JSS), and Turnover Intention Inventory Scale (TIIS). Data were analyzed using descriptive and inferential statistical tools. Results: Nurses' ages were found to significantly influence their turnover intentions. Job satisfaction (β = -0.47, p = 0.001) and job stress (β = 0.23, p = 0.001) strongly predicted turnover intentions in the nurses. The mean values for the job satisfaction scale, job stress scale, and turnover intention inventory scale were 3.13 (SD = 0.60), 2.74 (SD = 0.71), and 2.43 (SD = 0.67) respectively. Conclusions: Several predictors of turnover intentions were determined in this study through nurses' age, job satisfaction, and job stress as being the most influential factors. Efforts to increase nurses' job satisfaction and reduce job stress should be implemented to halt further loss of these skilled groups of healthcare professionals. 1. Introduction Nursing turnover remains a challenging issue within the concerns for those in nursing management. Intentions for nurse turnover has been defined in the literature as the individual nurses' decision for leaving a nursing unit and perhaps even leaving the facility (Brewer, Kovner, Greene, Tukov-Shuser, & Djukic, 2012; Flinkman, Leino-Kilpi, & Salanterä, 2010; Toren et al., 2012). The literature suggested that nurse turnover intentions range from 4% to 68% (El-Jardali, Dimassi, Dumit, Jamal, & Mouro, 2009; Flinkman et al., 2010; Hasselhorn et al., 2008; Sabanciogullari & Dogan, 2015). In a cross-sectional observa- tional study conducted in 10 countries, 33% of staff nurses reported the intention to leave their current hospital facility while 9% reported the intention to leave their current profession (Heinen et al., 2013). The cost and burden of turnover intention in nurses are well documented in the nursing literature. High turnover in nurses are attributed to the high incidence of medical errors, adverse patient events and errors, and the low quality of patient care (North et al., 2013; O'Brein-Pallas, Murphy, Shamian, Li, & Hayes, 2010). Turnover affects the morale of the remaining staff, reduces their motivation to work, and eventually their productivity (Hayes et al., 2012; Jones & Gates, 2007). For the organization, turnover may impact the hospital budget as it entails the need for use of temporary overtime, orientation and training for new staff, continuous recruitment, advertising and hiring (North et al., 2013; O'Brein-Pallas et al., 2010; Roche, Duffield, Dimitrelis, & Frew, 2015). Approximations of turnover costs ranged from around $20,561 (USA) with an upper range to $48,790 (Australia) per nurse turnover (Duffield, Roche, Homer, Buchan, & Dimitrelis, 2014). In light of these current trends in nurse turnover, efforts must be made to maintain an organizationally committed nursing workforce and prevent massive nurse turnover. https://doi.org/10.1016/j.apnr.2017.11.027 Received 16 March 2017; Received in revised form 9 September 2017; Accepted 19 November 2017 ⁎ Corresponding author at: Al Khoudh, Muscat, Oman. E-mail address: leodoroj@squ.edu.om (L.J. Labrague). Applied Nursing Research 39 (2018) 200–206 0897-1897/ © 2017 Elsevier Inc. All rights reserved. T