Healthcare Staff Wellbeing Research Articles

Design of healthcare structures by green standards

Global warming is real, and the healthcare industry is both a contributor and a victim. Also, physical setting and, in particular, sustainable design practices can support patient recovery during hospitalization. In the context of this paper, focus areas for design of green healthcare structures have been explored in detail. Herein, we are laying focus on understanding architecturally justified approaches of interior lighting in a healthcare setting. This paper also discusses design strategies to improve indoor air quality in hospitals and the current international research to improve indoor air quality are reported. Other focus areas like greenhouse keeping, use of green interior materials and landscaping are discussed. Data for the review was extracted from published books and diverse online sources with the help of the Google search engine. It was found that healthcare structures, being resource intensive establishments, consume vast amounts of energy, water, and construction materials to provide high quality care. It was also found that healthcare institutions, by adopting sustainable measures are capable of reducing their environmental footprint to a bigger extent, boost the wellbeing of healthcare staff and aid patient recovery.

The impact of work-related travel on trainee doctors.

British Journal of Hospital MedicineVol. 80, No. 5 EditorialThe impact of work-related travel on trainee doctorsis corrected byCorrigendumMarissa Lewis, Holly Singer, Ella Ayden, M Aamer SarfrazMarissa LewisDr M Lewis (E-mail Address: [email protected])FY1, Department of Psychiatry, Littlebrook Hospital, Dartford DA2 6PPSearch for more papers by this author, Holly SingerFY2, Department of Psychiatry, Littlebrook Hospital, DartfordSearch for more papers by this author, Ella AydenFY2, Department of Psychiatry, Littlebrook Hospital, DartfordSearch for more papers by this author, M Aamer SarfrazConsultant Psychiatrist and Director of Medical Education, Department of Psychiatry, Littlebrook Hospital, DartfordSearch for more papers by this authorMarissa Lewis; Holly Singer; Ella Ayden; M Aamer SarfrazPublished Online:6 May 2019https://doi.org/10.12968/hmed.2019.80.5.246AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Besser LM, Marcus M, Frumkin H. Commute time and social capital in the U.S. Am J Prev Med. 2008 Mar;34(3):207–211. https://doi.org/10.1016/j.amepre.2007.12.004 Crossref, Medline, Google ScholarChristian TJ. Trade-offs between commuting time and health-related activities. J Urban Health. 2012 Oct;89(5):746–757. https://doi.org/10.1007/s11524-012-9678-6 Crossref, Medline, Google ScholarHall LH, Johnson J, Watt I, Tsipa A, O'Connor DB. Healthcare staff wellbeing, burnout and patient safety: a systematic review. PLoS One. 2016 Jul 8;11(7):e0159015. https://doi.org/10.1371/journal.pone.0159015 Crossref, Medline, Google ScholarKnott CS, Panter J, Foley L, Ogilvie D. Changes in the mode of travel to work and the severity of depressive symptoms: a longitudinal analysis of UK Biobank. Prev Med. 2018 Jul;112:61–69. https://doi.org/10.1016/j.ypmed.2018.03.018 Crossref, Medline, Google ScholarPage NC, Nilsson VO. Active commuting: workplace health promotion for improved employee well-being and organisatonal behaviour. Front Psychol. 2017 Jan 10;7(7). https://doi.org/10.3389/fpsyg.2016.01994 Medline, Google ScholarPohanka M, Fitzgerald S. Urban sprawl and you: how sprawl adversely affects worker health. AAOHN J. 2004 Jun;52(6):242–246. Crossref, Medline, Google ScholarRimmer A. Employers must tackle high level of burnout among trainees, say GMC. BMJ. 2018 Jul 9;362:k3018. https://doi.org/10.1136/bmj.k3018 Crossref, Medline, Google ScholarThe NHS Staff Council. 2018. NHS Terms and Conditions of Service Handbook. (accessed 22 December 2018) https://www.nhsemployers.org/tchandbook Google ScholarUrhonen T, Lie A, Aamodt G. Associations between long commutes and subjective health complaints among railway workers in Norway. Prev Med Rep. 2016 Dec;4(4):490–495. https://doi.org/10.1016/j.pmedr.2016.09.001 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetailsRelated articlesCorrigendum22 Aug 2019British Journal of Hospital Medicine 2 May 2019Volume 80Issue 5ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 6 May 2019 Published in print 2 May 2019 Information© MA Healthcare LimitedPDF download

A study on perceptions of Doctors on violence againsthealthcare workers in India

Background According to a study by the Indian Medical Association over 75 of doctors have faced violence at work. These attacks have impact on the psychological and physical well-being of healthcare staff. As a consequence this violence compromises the quality of care and puts health-care provision at risk. Objective To understand the perceptions of doctors on causes and the prevention of violence against healthcare workers.Methodology 30 In depth interviews were conducted with residents of a Government medical college in Karnataka. Atlasti 7.0 trial version was used.Results Illiteracy lack of trust on treating doctors emotional aspects lack of communication skills negligence inadequately trained staff and administrative issues were reflected as main causes ofviolence in the current study. Adequate staff capacity building and rectifying administrative lacunae s were the steps suggested to curtail such violence in the institution.Conclusion Every healthcare institution must setup their own policy for prevention of violence and appoint a committee to review the incidents periodically

Safety and wellbeing as spatial capacities: An analysis from two ethnographic studies in primary care and palliative care contexts

Patient safety and quality of care are increasing concerns for healthcare internationally. This paper examines the spatial achievement of safety and wellbeing by healthcare staff, patients and their carers within UK primary care and Australian palliative care contexts. Two key socio-spatial modes of safety and wellbeing were found across these healthcare contexts. The technical mode was spatially managed by staff and driven by formal approaches to safety with a limited focus on wellbeing. In contrast, the relational mode was driven by attentiveness to the wellbeing and spatial engagement of staff, patients and carers that drew on informal elements of safety. Both modes extended across public, private, biomedical and administrative spaces, with technical and relational safety-wellbeing configurations often inhabiting the same spaces. Differences also existed across primary and palliative care contexts that reflected the unique pressures present within each context, and the ability of people and places to adapt to these demands. In the context of increasing workloads in healthcare internationally, this study highlights the benefits of attending as much to the relational dimensions of safety and quality of care as to the technical ones through increased focus on the safety and wellbeing of healthcare staff, patients and carers within and beyond traditional sites of care.

Can Schwartz Center Rounds support healthcare staff with emotional challenges at work, and how do they compare with other interventions aimed at providing similar support? A systematic review and scoping reviews

Objectives(i) To synthesise the evidence-base for Schwartz Center Rounds (Rounds) to assess any impact on healthcare staff and identify key features; (ii) to scope evidence for interventions with similar aims,...

Fluid balance in peri-operative and critical care staff

Dehydration is known to have detrimental effects on cognitive function and physical performance, as well as increasing the long-term risk of hypertension, coronary heart disease and stroke.1 A number of studies have shown inadequate nutritional and fluid intake in doctors.2,3 There is increasing evidence and interest in the importance of healthcare staff wellbeing and its implications for patient safety.4 A prospective, observational cohort study was conducted on medical and nursing staff working in peri-operative and critical care medicine at a tertiary teaching hospital over a 24 hour period. Fluid balance charts were distributed to staff who were asked to complete these for the duration of their shift. Using 2500 mls as the recommended daily fluid intake1 and average waking hours as 17,5 147 mls/hour was used as the standard with which to compare our results. Analysis was conducted using an unpaired Student t test. One-hundred-and-thirty-five fluid balance charts were distributed and 79 completed, giving a response rate of 58%. Only 3.8% of staff met the recommended fluid intake (n=3). The mean fluid intake was 76 mls/hr (± SD 32). On-call staff had a significantly lower fluid intake than those on normal shifts (24 vs. 78 mls/hr (p=0.005)). Night staff had a higher fluid intake than day staff (93 vs. 72 mls/hr (p=0.043)). Forty-seven percent of drinks consumed were caffeinated (± SD 35%). Staff passed urine 2.2 times per shift (± SD 1.0). This study found inadequate fluid intake amongst most medical and nursing staff. Study participants suggested reasons such as lack of time, limited availability of drinking facilities and staffing shortages. In spite of the small sample size, with over 96% of staff not meeting the recommended fluid intake, our results have potential implications for staff and patient safety. Dehydrated staff may be unable to perform as well cognitively and risk potentially detrimental effects on their short and long-term health. This study adds weight to existing research and highlights the need for fluid promotion among healthcare staff. 1.Benelam B, Wyness L. Nutrition Bulletin. 2010; 35: 3–25.2.Parshuram CS. Canadian Medical Assocociation Journal. 2004; 170: 965–970.3.Lemaire JB, Wallace JE, Dinsmore K, Roberts D. Nutrition Journal. 2011; 10: 18.4.Hamidi MS, Boggild MK, Cheung AM. Postgraduate Medical Journal. 2016; 92: 478–481.5.Nathaniel W, Badr MS, Belenky G, Bliwise DL, Buxton OM. Sleep. 2015; 38: 843–844.

Mental healthcare staff well-being and burnout: Anarrative review of trends, causes, implications, and recommendations for future interventions.

Rising levels of burnout and poor well-being in healthcare staff are an international concern for health systems. The need to improve well-being and reduce burnout has long been acknowledged, but few interventions target mental healthcare staff, and minimal improvements have been seen in services. This review aimed to examine the problem of burnout and well-being in mental healthcare staff and to present recommendations for future research and interventions. A discursive review was undertaken examining trends, causes, implications, and interventions in burnout and well-being in healthcare staff working in mental health services. Data were drawn from national surveys, reports, and peer-reviewed journal articles. These show that staff in mental healthcare report poorer well-being than staff in other healthcare sectors. Poorer well-being and higher burnout are associated with poorer quality and safety of patient care, higher absenteeism, and higher turnover rates. Interventions are effective, but effect sizes are small. The review concludes that grounding interventions in the research literature, emphasizing the positive aspects of interventions to staff, building stronger links between healthcare organizations and universities, and designing interventions targeting burnout and improved patient care together may improve the effectiveness and uptake of interventions by staff.

A systematic mixed-methods review of interventions, outcomes and experiences for midwives and student midwives in work-related psychological distress

Backgroundwithin challenging work environments, midwives and student midwives can experience both organisational and occupational sources of work-related psychological distress. As the wellbeing of healthcare staff directly correlates with the quality of maternity care, this distress must be met with adequate support provision. As such, the identification and appraisal of interventions designed to support midwives and student midwives in work-related psychological distress will be important in the pursuit of excellence in maternity care. Objectivesto identify interventions designed to support midwives and/or student midwives in work-related psychological distress, and explore any outcomes and experiences associated with their use.Data sources; study eligibility criteria, participants, and interventions This systematic mixed-methods review examined 6 articles which identified interventions designed to support midwives and/or student midwives in work-related psychological distress, and reports both the outcomes and experiences associated with their use. All relevant papers published internationally from the year 2000 to 2016, which evaluated and identified targeted interventions were included. Study appraisal and synthesis methodsthe reporting of this review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The quality of each study has been appraised using a scoring system designed for appraising mixed-methods research, and concomitantly appraising qualitative, quantitative and mixed-methods primary studies in mixed reviews. Bias has been assessed using an assessment of methodological rigor tool. Whilst taking a segregated systematic mixed-methods review approach, findings have been synthesised narratively. Findingsthis review identified mindfulness interventions, work-based resilience workshops partnered with a mentoring programme and the provision of clinical supervision, each reported to provide a variety of both personal and professional positive outcomes and experiences for midwives and/or student midwives. However, some midwives and/or student midwives reported less favourable experiences, and some were unable to participate in the interventions as provided for practical reasons. Limitationseligible studies were few, were not of high quality and were limited to international findings within first world countries. Additionally, two of the papers included related to the same intervention. Due to a paucity of studies, this review could not perform sensitivity analyses, subgroup analyses, meta-analysis or meta-regression. Conclusions and implications of key findingsthere is a lack of evidence based interventions available to support both midwives and student midwives in work-related psychological distress. Available studies reported positive outcomes and experiences for the majority of participants. However, future intervention studies will need to ensure that they are flexible enough for midwives and student midwives to engage with. Future intervention research has the opportunity to progress towards more rigorous studies, particularly ones which include midwives and student midwives as solitary population samples

Staff well-being in high-risk operating room environment: Definition, facilitators, stressors, leadership, and team-working—A case-study from a large teaching hospital

ABSTRACTPurpose: The purpose of this case-study is to critically evaluate the relationship between healthcare staff well-being and effective team-working in high-risk operating rooms (OR) environment.Background: Evidence suggests that positive staff well-being is associated with better patient care. However, healthcare organisations are lagging behind in prioritising staff well-being. It is acknowledged that delivery of multi-disciplinary care is proportional to effective team-working. The input-process-output (IPO) model theorises the relationship between staff well-being and effective team-working; however, the model's applicability has not been studied in high-risk OR environment.Methodology: Qualitative data were gathered, through semi-structured interviews, from OR nurses working in a large teaching hospital and content analysis was used to identify themes in the written responses.Findings: Five main themes emerged from the data; (i) participants linked well-being with happiness, job satisfaction, and being valued and recognised, (ii) participants held that unscrupulous organisational culture rears negative well-being, (iii) participants strongly argued that healthcare organisation must invest in staff well-being otherwise patient care will suffer, (iv) effective leadership is key to positive well-being and bad leadership behaviours are responsible for negative well-being and low-morale and (v) participants unanimously agreed that well-being drives effective team-working and not the converse.Value: The case-study identifies emotional well-being a key driver for effective team-working and ascertains that strong organisational support and compassionate leadership are critical to nurturing staff well-being. It challenges the widely held IPO model's notion that effective team-working promotes well-being in high-risk OR environment.Implications for nursing management: Case-study invites nurse managers to re-evaluate widely used three-staged (IPO) system approach towards creating an effective team-working in high-risk OR environment.

Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review.

ObjectiveTo determine whether there is an association between healthcare professionals’ wellbeing and burnout, with patient safety.DesignSystematic research review.Data SourcesPsychInfo (1806 to July 2015), Medline (1946 to July 2015), Embase (1947 to July 2015) and Scopus (1823 to July 2015) were searched, along with reference lists of eligible articles.Eligibility Criteria for Selecting StudiesQuantitative, empirical studies that included i) either a measure of wellbeing or burnout, and ii) patient safety, in healthcare staff populations.ResultsForty-six studies were identified. Sixteen out of the 27 studies that measured wellbeing found a significant correlation between poor wellbeing and worse patient safety, with six additional studies finding an association with some but not all scales used, and one study finding a significant association but in the opposite direction to the majority of studies. Twenty-one out of the 30 studies that measured burnout found a significant association between burnout and patient safety, whilst a further four studies found an association between one or more (but not all) subscales of the burnout measures employed, and patient safety.ConclusionsPoor wellbeing and moderate to high levels of burnout are associated, in the majority of studies reviewed, with poor patient safety outcomes such as medical errors, however the lack of prospective studies reduces the ability to determine causality. Further prospective studies, research in primary care, conducted within the UK, and a clearer definition of healthcare staff wellbeing are needed.ImplicationsThis review illustrates the need for healthcare organisations to consider improving employees’ mental health as well as creating safer work environments when planning interventions to improve patient safety.Systematic Review RegistrationPROSPERO registration number: CRD42015023340.

Efficacy of mindfulness based stress reduction (MBSR) on the sense of wellbeing of healthcare staff: A pilot study

active management of third stage labour. The medical model for understanding the causes of PPH based on the four T’s (tone, tissue, trauma, and thrombin) will be critiqued as incomplete and inadequate. We will argue that the high rates of PPH in obstetric units reflect the reductionisticmedicalmodelof labourphysiologywhich ignores the impact of the environment and the emotions. This study poses the question: does immediate skin to skin contact and early breast feeding affect the rates of postpartum haemorrhage (PPH) and if so why? Institutional ethical approval was obtained. Following extraction from the Obstetrix data base the records of over 10,000 women were analysed. Descriptive statistics provided information on frequencies and percentages and logistic regression and odds ratio (OR) were conducted to identify and predict relationships. When a woman had skin to skin contact with her baby at birth she was less likely to have a PPH (p<0.0001, OR2.704, CI-2.217–3.297). When a woman breastfed her baby after birth she was less likely to have a PPH (p<0.0001, OR-1.578 CI1.334–1.866). When a woman had continuity of midwifery care at the standalone birth centre or at home she was less likely to have a PPH (p<0.0001, OR-2.563, CI-1.640–4.005).The cascade of endogenous oxytocin occurs most and acts most effectively when physiological care is provided in labour.It is best practice for physiological care to continue into the 3rd and 4th stages of labour and thereby minimises PPH rates.

Creating a positive workplace culture

This article considers the link between emotional resilience and the mental and physical wellbeing of healthcare staff, and how this affects leadership and patient care. The authors outline six steps to building and sustaining emotional resilience. In two NHS surveys (Boorman 2009, Healthcare Commission 2010) staff reported that their physical health and emotional wellbeing affected their ability to undertake daily activities and their ability to care for patients. Some NHS trusts are addressing staff wellbeing through emotional resilience training. Guy's and St Thomas' NHS Foundation Trust, London, for example, includes it in its preceptorship programme, which supports transition from student to staff nurse.

The health of health care organizations

Abstract This paper explores the nature and development of health care organizations in terms of a model of organizational healthiness. The model places particular emphasis on the psychosocial subsystems which describe the subjective organization. These represent the perceived internal functioning of the organization in terms of task completion, problem solving and staff development. The implications of such a model for the well-being of health care staff and for the evaluation of service delivery are discussed.