Workforce & Health Systems publications

Meredith P, Turner L, Saville C, Griffiths P

Nurses play a crucial role in maintaining the safety of surgical patients. Few nurse staffing studies have looked specifically at surgical patients to examine the impact of exposure to low staffing on patient outcomes.

A longitudinal patient analysis was conducted in four organizations in England using routine data from 213 910 admissions to all surgical specialties. Patients' staffing exposures were modelled as counts of understaffed registered nurse and nurse assistant days in the first 5 inpatient days. Understaffing was identified when staffing per patient-day was below the mean for the ward. Cox models were used to examine mortality within 30 days of admission and readmission within 30 days of discharge. Generalized linear models were used to investigate duration of hospital stay and occurrence of hospital-acquired conditions.

https://doi.org/10.1093/bjs/znae215

August 2024

Griffiths   P, Saville C, Ball J, Culliford D, Jones J, Lambert F, et al

Many studies show the adverse consequences of insufficient nurse staffing in hospitals, but safe and effective staffing is unlikely to be just about staff numbers. There are considerable areas of uncertainty, including whether temporary staff can safely make up shortfalls in permanent staff and whether using experienced staff can mitigate the effect of staff shortages.

The objective of this study is to explore the association of the composition of the nursing team with the risk of patient deaths.

https://doi.org/10.1001/jamanetworkopen.2024.28769

August 2024

Maben J, Taylor C, Jagosh J, Carrieri D, Briscoe S, Klepacz N, Mattick K

Nurses, midwives and paramedics are the largest collective group of clinical staff in the National Health Service and have some of the highest prevalence of psychological ill-health. Existing literature tends to be profession-specific and focused on individual interventions that place responsibility for good psychological health with nurses, midwives and paramedics themselves.

The aimof this study is to improve understanding of how, why and in what contexts nurses, midwives and paramedics experience work-related psychological ill-health; and determine which high-quality interventions can be implemented to minimise psychological ill-health in these professions.

https://doi.org/10.3310/twdu4109

April 2024

Klepacz N, Wadey E, Griffiths P, Woodnutt S, Snowden J, Smith C et al

Demand for mental health services is high, but so are vacancy levels for registered nurses in mental health. To effectively address the workforce disparity, we need to engage with nurses to understand better the rewards and challenges of being part of the UK's mental health nursing workforce. The aim of the study set out in this protocol will be to identify modifiable workplace factors impacting nurses' work lives and wellbeing.

https://doi.org/10.12968/bjmh.2023.0037

February 2024

Turner LY, Saville C, Ball J, Culliford D, Dall'Ora C, Jones J et al

Preventing readmission to hospital after giving birth is a key priority, as rates have been rising along with associated costs. There are many contributing factors to readmission, and some are thought to be preventable. Nurse and midwife understaffing has been linked to deficits in care quality. This study explores the relationship between staffing levels and readmission rates in maternity settings.

10.1136/bmjopen-2023-077710

April 2024

Remmington   C, Cameron L, Hanks F, Liang YH, Barrow L, Coxhead R et al

There is good evidence describing pharmacy workforce and service provision in general critical care units. However, no data exist from adult extracorporeal membrane oxygenation (ECMO) centres.

The aim of this study is to describe workforce characteristics, pharmacy service provision, and pharmaceutical care activities in critical care units (CCUs) providing an adult ECMO service in the United Kingdom (UK) and compare to national staffing standards for CCUs.

https://doi.org/10.1007/s11096-024-01719-9

April 2024

Turner  L, Ball J, Meredith P et al.

Independent inquiries have identified that appropriate staffing in maternity units is key to enabling quality care and minimising harm, but optimal staffing levels can be difficult to achieve when there is a shortage of midwives. The services provided and how they are staffed (total staffing, skill-mix and deployment) have been changing, and the effects of workforce changes on care quality and outcomes have not been assessed. This study aims to explore the association between daily midwifery staffing levels and the rate of reported harmful incidents affecting mothers and babies.

https://doi.org/10.1186/s12913-024-10812-8

March 2024

Andina-Díaz   E, Welch L, Siles-González J, Serrano-Fuentes N, Gutiérrez-García AI,   Solano-Ruiz M

Objective: To assess nursing students' experiences of using photovoice as a pedagogical approach to active learning in the community.

Methods: A descriptive design with a cross-sectional mixed-method questionnaire was used with 108 students following an educational activity, in which their communities were photographed and the impact of the pandemic on vulnerable populations was reflected. Descriptive statistics and thematic analysis were used to analyze the data.

https://doi.org/10.1111/phn.13285

February 2024

Ejebu OZ, Turnbull J, Atherton I, Rafferty AM, Palmer B, Philippou J, Prichard J, Jamieson M, Rolewicz L, Williams M, Ball J

Like many countries, England has a national shortage of registered nurses. Employers strive to retain existing staff, to ease supply pressures. Disproportionate numbers of nurses leave the National Health Services (NHS) both early in their careers, and later, as they near retirement age. Research is needed to understand the job preferences of early-career and late-career nurses working in the NHS, so tailored policies can be developed to better retain these two groups.

https://doi.org/10.1136/bmjopen-2023-075066

February 2024

Wieruszewski PM, Leone M, Kaas-Hansen BS, Dugar S, Legrand M, McKenzie CA, Bissell Turpin BD, Messina A, Nasa P, Schorr CA, De Waele JJ, Khanna AK

Objectives: To provide guidance on the reporting of norepinephrine formulation labeling, reporting in publications, and use in clinical practice.

Design: Review and task force position statements with necessary guidance.

https://doi.org/10.1097/ccm.0000000000006176

January 2024

Dall’Ora C, Ejebu OZ, Jones J, Griffiths P

Shifts of 12 hours or longer are common in nursing services within general hospital wards. Concerns have been raised about their safety, but previous research has mostly used staff-reported measures of quality and safety and has occurred in general hospital settings only. 

This study aims to measure the association between the use of 12+ hour shifts in nursing staff (including registered nurses, healthcare support workers or nursing assistants, and nursing associates) and the rate of patient incidents in mental health and community hospitals

https://doi.org/10.1155/2023/6626585

January 2024

Griffiths P, Turner L, Lown J, Sanders J

Birthrate Plus® is a widely used tool that informs decisions about the number of midwifery staff needed to provide safe and high quality care in maternity services. Evidence about the effectiveness, validity, reliability, and feasibility of tools such as this is needed.

https://doi.org/10.1016/j.wombi.2023.11.003

January 2024