Workforce & Health Systems publications
Paramedics providing end-of-life care: an online survey of practice and experiences
Campling N, Turnbull J, Richardson A, Voss S, Scott-Green J, Logan S, Latter S
Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this.
Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics' current practice and experiences providing end-of-life care was undertaken.
https://doi.org/10.1186/s12904-024-01629-7
December 2024
Workforce & Health Systems
Nurse understaffing associated with adverse outcomes for surgical admissions
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
Workforce & Health Systems
Nursing Team Composition and Mortality Following Acute Hospital Admission
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
Workforce & Health Systems
Causes and solutions to workplace psychological ill-health for nurses, midwives and paramedics: the Care Under Pressure 2 realist review
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
Workforce & Health Systems
A protocol for a cross-sectional survey exploring the work lives and wellbeing of the mental health nursing workforce in the UK
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
Workforce & Health Systems
Inpatient midwifery staffing levels and postpartum readmissions: a retrospective multicentre longitudinal study
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.
April 2024
Workforce & Health Systems
Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey
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
Workforce & Health Systems
The association between midwifery staffing and reported harmful incidents: a cross-sectional analysis of routinely collected data
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
Workforce & Health Systems
Photovoice: An active learning tool with community nursing students
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
Workforce & Health Systems
What might make nurses stay? A protocol for discrete choice experiments to understand NHS nurses' preferences at early-career and late-career stages
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
Workforce & Health Systems
Position Paper on the Reporting of Norepinephrine Formulations in Critical Care from the Society of Critical Care Medicine and European Society of Intensive Care Medicine Joint Task Force
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
Workforce & Health Systems
Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using Routinely Collected Data
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
Workforce & Health Systems