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

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Summary

Nurses and midwives seek flexible, equitable rosters to improve wellbeing and patient care, despite general satisfaction. Current practices impact health and work-life balance, necessitating updated guidelines for better outcomes.

Keywords:
FatigueHealth servicesHospitalsMidwiferyNursesOccupational healthRosteringShift work

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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.