Summary
Objective
To evaluate the impact of an organisational intervention aimed to reduce occupational
stress and turnover rates of 55% in hospital nurses.
Design
The evaluation used a pre- and post-intervention design, triangulating data from surveys
and archival information.
Setting
Two public hospitals (H1 and H2) in the Northern Territory (NT) Australia participated
in the intervention.
Subjects
484 nurses from the two NT hospitals (H1, Wave 1, N = 103, Wave 2, N = 173; H2, Wave 1, N = 75, Wave 2, N = 133) responded to questionnaires administered in 2008 and in 2010.
Measures
The intervention included strategies such as the development and implementation of
a nursing workload tool to assess nurse workloads, roster audits, increased numbers
of nursing personnel to address shortfall, increased access to clinical supervision
and support for graduates, increased access to professional development including
postgraduate and short courses, and a recruitment campaign for new graduates and continuing
employees. We used an extended Job Demand-Resources framework to evaluate the intervention
and 17 evaluation indicators canvassing psychological distress, emotional exhaustion,
work engagement, job satisfaction, job demands, job resources, and system factors
such as psychosocial safety climate. Turnover rates were obtained from archival data.
Results
Results demonstrated a significant reduction in psychological distress and emotional
exhaustion and a significant improvement in job satisfaction, across both hospitals,
and a reduction in turnover in H2 from 2008 and 2010. Evidence suggests that the intervention
led to significant improvements in system capacity (adaptability, communication) in
combination with a reduction in job demands in both hospitals, and an increase in
resources (supervisor and coworker support, and job control) particularly in H1.
Conclusions
The research addresses a gap in the theoretical and intervention literature regarding
system/organisation level approaches to occupational stress. The approach was very
successful on a range of health, work outcome, and job design indicators with results
providing compelling evidence for the success of the system/organisational level intervention.
The quasi-experimental design enabled us to conclude that improvements for the nurses
and midwives could be attributed to the organisational intervention by the NT Department
of Health (DoH). Further research should be undertaken to explore longer-term impacts,
and particularly the influence on turnover. Levels of stress in hospital nurses remain
high and present important implications for the psychological well-being of staff.
Keywords
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Article info
Publication history
Published online: August 30, 2012
Accepted:
July 6,
2012
Received in revised form:
July 4,
2012
Received:
October 24,
2011
Identification
Copyright
© 2012 Royal College of Nursing, Australia. Published by Elsevier Inc. All rights reserved.
