Investigation of the causes and effects of stress in nurses working 'floating shifts'.

BACKGROUND: Nurses working in hospitals may occasionally be reassigned to other wards for various reasons, for example to cover sudden absences or to support heavier-than-usual workloads. This practice is known as 'floating shifts'. AIM: To assess how nurses are affected by the stress of working floating shifts, to understand what causes and alleviates this stress and to identify strategies that can be used to reduce stress. METHOD: A cross-sectional research study which used an online survey. RESULTS: Data were collected from 1,334 nurses in nine Finnish hospitals. Of these respondents, 63% (n=846) had worked floating shifts. Data analysis showed that having worked floating shifts in the past 12 months was not associated with increased reports of ongoing stress. However, respondents identified factors that they found stressful during floating shifts, such as the lack of a work partner. CONCLUSION: Nurse managers should consider how floating shifts are administered so that nurses feel supported when working on a different ward or unit. Nurse managers can greatly influence nurses' ability to manage floating shifts.

A systematic review on randomized controlled trials: Coaching elements of digital services to support chronically ill adolescents during transition of care.

AIMS: To define digital health services that have been studied among chronically ill adolescents and to describe e-health coaching elements that may have an impact on transition outcomes. DESIGN: Systematic review without meta-analysis. DATA SOURCES: MEDLINE (Ovid), Pub Med, Scopus and CINAHL on 28 May 2018. REVIEW METHODS: Peer-reviewed articles published between January 2008-May 2018 were reviewed following the Cochrane Handbook for Systematic Reviews of Interventions and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. RESULTS: Twelve randomized controlled trials were included. The interventions varied significantly in duration and content. E-coaching that included human and social support showed positive impact on transition outcomes. Digital health services incorporated into usual care provide efficient and accessible care. CONCLUSION: E-coaching elements enable tailoring and personalization and present a tool for supporting and motivating chronically ill adolescents during transition of care. Future research should evaluate the effectiveness of e-coaching elements. IMPACT: Digital services are considered a means for increasing adolescents' motivation for self-care and for increasing their accessibility to health care. The coaching elements in digital services consist of a theoretical basis, human support, interactive means and social support. Included interventions varied in terms of duration, dose, content and design. Our results may serve the development of digital health services for adolescents in transition. E-coaching can be used to engage and motivate chronically ill adolescents to improve health behaviour and self-management during transition of care.

Comparing the Two Techniques for Nursing Staff Rescheduling to Streamline Nurse Managers' Daily Work in Finland.

The aim of this study was to identify nurse managers' daily tasks during the rescheduling of sudden nursing staff absences by comparing two techniques: a paper-based system as phone calls and emails or information technology-based staffing systems. In addition, it is intended to evaluate the usability of information technology-based staffing solutions and evaluate estimated cost savings by using hospital permanent staff to cover sudden absences. A quasi-experimental pretest and posttest one-group study design was used to evaluate nurse managers' (n = 61) daily tasks (n = 5800) during rescheduling nursing staff sudden absences (n = 2628); furthermore, we engaged in observations and provided estimates of cost savings generated by our proposed intervention. The number of nurse manager tasks during rescheduling decreased significantly (P < .001) as well as unstaffed shifts (P < .001) and unplanned shift changes (P < .001) after the information technology-based scheduling system was implemented. The usability score ranged from 76 to 100, showing that the information technology-based scheduling solution has good usability. The use of information technology-based staffing solution can streamline the rescheduling process, save nurse managers time for other activities, and offer organizations opportunities for cost savings.

A real-time Excel-based scheduling solution for nursing staff reallocation.

Aim This article describes the development and testing of an Excel-based scheduling solution for the flexible allocation and reallocation of nurses to cover sudden, unplanned absences among permanent nursing staff. Method A quasi-experimental, one group, pre- and post-test study design was used ( Box 1 ) with total sampling. Participants (n=17) were selected purposefully by including all ward managers (n=8) and assistant ward managers (n=9) from one university hospital department. The number of sudden absences among the nursing staff was identified during two 4-week data collection periods (pre- and post-test). Results During the use of the paper-based scheduling system, 121 absences were identified; during the use of the Excel-based system, 106 were identified. The main reasons for the use of flexible 'floating' nurses were sick leave (n=66) and workload (n=31). Other reasons (n=29) included patient transfer to another hospital, scheduling errors and the start or end of employment. Conclusion The Excel-based scheduling solution offered better support in obtaining substitute labour inside the organisation, with smaller employment costs. It also reduced the number of tasks ward managers had to carry out during the process of reallocating staff.