Developing nurse and midwife centred rostering principles using co-design: a mixed-methods study

Area of Science:

• Healthcare Management
• Nursing and Midwifery Practice
• Workforce Wellbeing

Background:

• Current nursing and midwifery rostering guidelines may not meet contemporary health service or staff needs.
• Existing practices are linked to decreased job satisfaction, poor health, and high staff turnover.
• There is limited understanding of Australian nurses' and midwives' rostering needs and preferences.

Purpose of the Study:

• To identify concerns, needs, and preferences regarding nursing and midwifery rosters.
• To co-design acceptable, equitable, and feasible rostering principles.
• To address the impact of current rostering on staff wellbeing and patient care.

Main Methods:

• A mixed-methods co-design approach was employed.
• Data collection included surveys, discussion groups, and co-design workshops.
• Participants were nurses and midwives from three public health services in Victoria, Australia.

Main Results:

• Most nurses and midwives (688/715) reported general roster satisfaction, but many experienced fatigue and unmet requests.
• Over 60% had commitments impacting availability, and over 50% took leave due to fatigue or unmet requests.
• Midwives reported significantly lower satisfaction and more challenges than nurses; managers spent considerable time on roster preparation.

Conclusions:

• Nurses and midwives desire flexible, fair, and equitable rosters to manage commitments and reduce fatigue.
• Current rostering practices negatively affect staff health, work, and personal lives.
• Co-designed principles emphasize flexibility, equity, and fatigue management for improved care and wellbeing.