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This study presents a quantitative analysis of the strategic role of job embeddedness on turnover intention among nurses in selected healthcare centres in urban Accra, Ghana. Focusing on both on-the-job and off-the-job embeddedness, the study aims to develop a predictive model as a complement to evidence-based policies on human resources to help improve the existing retention of nurses in the healthcare sector. A sample of 276 nurses was randomly selected to participate in the study. Structured questionnaires were administered through digital formats to enable selected respondents to provide data for analyses. The authors employed descriptive statistics in SPSS Version 28 to analyse the data, while Structural Equation Modelling with SmartPLS 3.0 was used to assess the relationships among the variables. By adopting an ecosystem and strategic perspective, this paper considers the role of on-the-job embeddedness as a vital stability mechanism in healthcare systems. Conversely, off-the-job embeddedness emerged as a comparatively weaker influence. The results underscore the need to improve organisational embeddedness as a strategic approach to curtail turnover and enhance healthcare service within healthcare facilities in Ghana.

Concerns about nurse attrition are mounting. Despite this, limited empirical evidence exists on how different dimensions of burnout and institutional support interact in this context. This study investigates how burnout influences nurses’ turnover intention (TI) in urban Ghana and examines whether institutional support mitigates this relationship. A cross-sectional survey design was employed to collect data from 245 nurses across five Christian-based hospitals. Primary data is analysed and aided by the Partial Least Squares Structural Equation Modelling (PLS-SEM) in addition to conducting direct evaluation to assess the moderating influences. The findings revealed that emotional exhaustion has a significant impact on TI, whereas depersonalisation has no direct effect. Institutional support also significantly reduces TI. In addition, emotional support strongly moderates the link between emotional exhaustion and TI, while access to resources partially moderates the effect of depersonalisation. The study shows that the negative effects of burnout on TI can be reduced through strong institutional support systems. The outcomes reinforce the applicability of Job Demands-Resources and Social Exchange theories and recommend more investment in both tangible resources and emotional support mechanisms to enhance nurse retention in high-demand urban healthcare ecosystems.