Booker Lauren A, Mills Jane, Bish Melanie, Spong Jo, Deacon-Crouch Melissa, Skinner Timothy C
School of Psychology & Public Health, La Trobe University, Bendigo, VIC, 3552, Australia.
Institute for Breathing and Sleep, Austin Health, Melbourne, 3084, Australia.
BMC Nurs. 2024 Apr 29;23(1):295. doi: 10.1186/s12912-024-01949-2.
Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the organisation has a responsibility to make sure all reasonable measures are taken to reduce fatigue of staff. Therefore, it is important to assess what the current rostering processes is for staff responsible for creating the rosters for nurses.
The aims of the project were to understand (1) who creates the rosters and what the process is, (2) what training and knowledge these staff have in establishing rostering schedules that optimise the sleep and wellbeing of staff, and (3) what the benefits and limitations are of current rostering practices.
Findings were generated through semi-structured interviews, using cluster coding to form categories. Twenty four nurses responsible for rostering staff were interviewed from three different sites in Victoria (one metropolitan and two regional/rural hospitals). Data was analysed using selected grounded theory methods with thematic analysis.
The common themes that came out of the interviews were that rostering staff were under prepared, unaware of fatigue and safety guidelines and polices from governing bodies and had not received any education or training before taking on the role. The most common rostering style was self-rostering, where staff could submit preferences. However, there were concerns about staff fatigue but were divided as to who should be responsible, with many saying it was up to staff to preference shifts that they could cope with. The final theme was cultural barriers to change.
While self-rostering resulted in staff having more freedom and flexibility, shift preferences may be influenced more so by a need to fit with lifestyle rather than to minimise fatigue and increase safety in the workplace. Greater consideration of the impact of shift work schedules on fatigue is required to ensure that the layers of clinical governance in health care organisations minimise the risk of occupation health and safety issues for employees delivering direct patient care.
实施适当的轮班工作计划有助于降低医护人员睡眠障碍风险并减轻疲劳，从而降低职业健康与安全风险。在澳大利亚，机构有责任确保采取一切合理措施来减轻员工疲劳。因此，评估负责为护士制定排班表的员工当前的排班流程非常重要。
该项目的目的是了解：（1）谁制定排班表以及流程是什么；（2）这些员工在制定优化员工睡眠和福祉的排班表方面有哪些培训和知识；（3）当前排班做法的益处和局限性是什么。
通过半结构化访谈得出研究结果，采用聚类编码形成类别。从维多利亚州的三个不同地点（一家大都市医院和两家地区/农村医院）采访了24名负责员工排班的护士。使用选定的扎根理论方法和主题分析对数据进行分析。
访谈中出现的共同主题是，排班人员准备不足，不了解管理机构的疲劳和安全指南及政策，并且在担任该角色之前未接受任何教育或培训。最常见的排班方式是自我排班，员工可以提交偏好。然而，有人担心员工疲劳，但对于谁应负责存在分歧，许多人表示应由员工自行选择他们能够应对的班次。最后一个主题是变革的文化障碍。
虽然自我排班使员工有更多自由和灵活性，但班次偏好可能更多地受到适应生活方式需求的影响，而不是为了尽量减少疲劳和提高工作场所安全性。需要更多地考虑轮班工作计划对疲劳的影响，以确保医疗保健机构的临床管理层面将为直接提供患者护理的员工带来职业健康与安全问题的风险降至最低。
