Open Access Open Badges Review

Interventions for supporting nurse retention in rural and remote areas: an umbrella review

Gisèle Mbemba1, Marie-Pierre Gagnon1*, Guy Paré2 and José Côté3

Author Affiliations

1 Hôpital St-François d’Assise, Research Center of the Centre Hospitalier Universitaire de Québec, 10 rue de l’Espinay, D6-727, G1L 3L5, Québec, QC, Canada

2 Department of Information Technology, 3000, chemin de la Côte-Sainte-Catherine, HEC Montréal, H3T 2A7, Montréal, QC, Canada

3 Faculty of Nursing Sciences, Pavillon Marguerite-d'Youville, C.P. 6128 succ. Centre-ville Université de Montréal, H3C 3J7, Montréal, QC, Canada

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Human Resources for Health 2013, 11:44  doi:10.1186/1478-4491-11-44

Published: 11 September 2013



Retention of nursing staff is a growing concern in many countries, especially in rural, remote or isolated regions, where it has major consequences on the accessibility of health services.


This umbrella review aims to synthesize the current evidence on the effectiveness of interventions to promote nurse retention in rural or remote areas, and to present a taxonomy of potential strategies to improve nurse retention in those regions.


We conducted an overview of systematic reviews, including the following steps: exploring scientific literature through predetermined criteria and extracting relevant information by two independents reviewers. We used the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) criteria in order to assess the quality of the reports.


Of 517 screened publications, we included five reviews. Two reviews showed that financial-incentive programs have substantial evidence to improve the distribution of human resources for health. The other three reviews highlighted supportive relationships in nursing, information and communication technologies support and rural health career pathways as factors influencing nurse retention in rural and remote areas. Overall, the quality of the reviews was acceptable.


This overview provides a guide to orient future rural and remote nurse retention interventions. We distinguish four broad types of interventions: education and continuous professional development interventions, regulatory interventions, financial incentives, and personal and professional support. More knowledge is needed regarding the effectiveness of specific strategies to address the factors known to contribute to nurse retention in rural and remote areas. In order to ensure knowledge translation, retention strategies should be rigorously evaluated using appropriate designs.

Nurse shortage; Nurse retention; Rural retention; Rural health services; Umbrella review