Although it is logical to expect that turnover would adversely affect patient care, ...in reality, we know very little about nurse turnover and retention in terms of quality of care and patient safety. in reality, we know very little about nurse turnover and retention in terms of quality of care and patient safety. There is a substantial body of research documenting the effects of nurse staffing on patient outcomes and quality of care ( Kane, Shamliyan, Mueller, Duval, & Wilt, 2007 ; Lankshear, Sheldon, & Maynard, 2005 ). Further, some studies even suggest a relationship between nurse turnover and factors that are related to quality of care ( Aiken, Clarke, Sloane, Sochalski, & Silber, 2002 ; Shortell et al., 1994 ) or intent to quit and quality-related measures ( Leiter, Harvie, & Frizzel, 1998 ). Yet there are very few reported studies that have examined the specific relationships between nurse turnover or retention and quality of care, or that have attempted to quantify the quality of care and patient safety costs related to nurse turnover and retention. One commonly cited study did report that organizations with low turnover rates (ranging between 4% and 12%) had lower risk-adjusted mortality and lower patient lengths of stay than did organizations with moderate (12% to 22%) or high (22% to 44%) turnover rates ( VHA, 2002 ). A Canadian study reported negative effects associated with nurse turnover and communications, medications management, compromised follow-up, client disengagement, illness exacerbation, and added burdens of caregiving for families ( Minore et al., 2005 ). Further studies are needed to investigate these relationships, and to document the causal mechanisms through which turnover and/or retention may affect quality of care and patient safety.