Healthcare Research

This portfolio of work focuses on improving patient safety and the health, safety, and well-being of staff in New Zealand hospitals, by improving the management of shift work and fatigue in our public hospitals. The approach is evidence-based and relies on integrating scientific, workforce and organisational expertise as well as international best practice.

Safer Nursing 24-7

Nurses are the largest group of health professionals in New Zealand and DHB-based nurses working in acute settings, who are the main focus of this project, account for approximately 40% of all Registered and Enrolled Nurses.

This project incorporates recent advances in science and safety management to develop and implement an evidence-based approach to managing shift work and fatigue of nurses in New Zealand hospitals, and is supported by extensive sector engagement and project promotional activities.

Key outputs from the project will include:

a nationwide survey of Registered and Enrolled DHB Nurses’ work patterns in 6 practice areas with high a priori risk of fatigue-related error
a fatigue risk assessment matrix based on the survey findings;
freely-available training materials for nurses and their managers on evidence-based strategies for improving fatigue and shift work management; and
a Code of Practice for shift work and fatigue management in hospital-based nursing, developed in collaboration with key stakeholders and with broad sector consultation.

Updates are available on the project website www.safernursing24-7.co.nz.

Collaborators: Professor Annette Huntington and Adjunct Associate Professor Leonie Walker (Massey University), Dr Jinny Willis (New Zealand Nurses Organisation)

Funders: major funder, Health Research Council of New Zealand; additional funders, New Zealand Lottery Grants Board, McCutchan Trust, Massey University

Junior Doctors

In 2003, a national survey of Resident Medical Officers (RMOs) working in New Zealand hospitals was undertaken in partnership with the Resident Doctors Association to: document current hours of work, shift work, and rostering of RMOs; compare these to the Australian Medical Association’s Code of Practice for rostering for hospital doctors; inform debate; and make recommendations on how current practices could be improved. From the survey data, a fatigue risk assessment matrix was developed that is now used routinely to evaluate RMO rosters in DHBs (John McKeefry, personal communication).

Collaborators (in alphabetical order: Dr Celia Briar, Dr Sandy Garden, Heather Purnell, Naomi Travier, Margo van den Berg, Prof Alistair Woodward

Major Funding: Health Research Council of New Zealand

Anaesthetists

Work in this portfolio included a national survey of anaesthetists practising in New Zealand, fatigue monitoring studies of registrars and specialists, theatre incident monitoring, structured interviews with specialists, simulation studies with registrars, and development and testing of a new intravenous drug administration system designed to reduce anaesthetic error.

Collaborators (alphabetical order): Dr Sandy Garden, Prof Stuart Henderson, Prof Alan Merry, Dr Michelle Millar, Dr Brian Robinson, Dr Craig Webster, Dr Jennifer Weller

Major Funding: Health Research Council of New Zealand

Jump to Publications

Primary Investigator(s)

Professor Philippa Gander

Professor Emeritus

p.h.gander@massey.ac.nz

See Profile

Dr Karyn O'Keeffe

Senior Lecturer

(+64) 4 979 3260

k.m.okeeffe@massey.ac.nz

See Profile

Others Involved

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Gander P
O'Keeffe K
Santos-Fernandez E
Huntington A
Walker L
Willis J
Gander, P., O'Keeffe, K., Santos-Fernandez, E., Huntington, A., Walker, L., & Willis, J. (2020). Development and evaluation of a matrix for assessing fatigue-related risk, derived from a national survey of nurses' work patterns. International Journal of Nursing Studies, 103573.

Gander, P
O’Keeffe, K
Santos-Fernandez, E
Huntington, A
Walker, L
Willis, J
Gander, P., O’Keeffe, K., Santos-Fernandez, E., Huntington, A., Walker, L., & Willis, J. (2019). Fatigue and nurses’ work patterns: An online questionnaire survey. International Journal of Nursing Studies, 98, 67-74.

Sweeney B
Sweeney, B & Wu, L. (2019). Perceptions, Skills, and Knowledge of Sleep-Related Difficulties and Their Treatment in a Cancer Psychosocial Workforce. Journal of the New Zealand College of Clinical Psychologists, 29(1), 3-12.

Garden A L
Robinson B J
Kappus L J
Macleod I
Gander P H
Garden, A. L., Robinson, B. J., Kappus, L. J., Macleod, I., & Gander, P. H. (2012). Fifteen-hour day shifts have little effect on the performance of taskwork by anaesthesia trainees during uncomplicated clinical simulation. Anaesth Intensive Care, 40(6), 1028-1034.

O'Keeffe K M
Gander P H
O’Keeffe KM and Gander PH (2012). Best practice Rostering, Shift Work and Hours of Work for Resident Doctors: A Review. Report commissioned by the National Resident Doctors Engagement Group. Wellington: Massey University SWRC.

Gander P
Briar C
Garden A
Purnell H
Woodward A
Gander, P., Briar, C., Garden, A., Purnell, H., & Woodward, A. (2010). A gender-based analysis of work patterns, fatigue, and work/life balance among physicians in postgraduate training. Academic Medicine, 85(9), 1526-1536.

Gander P H
Millar M
Webster C
Merry A
Gander, P. H., Millar, M., Webster, C., & Merry, A. (2008). Sleep loss and performance of anaesthesia trainees and specialists. Chronobiology International, 25(6), 1077-1091.

Gander P H
Purnell H M
Garden A L
Woodward A
Gander, P. H., Purnell, H. M., Garden, A. L., & Woodward, A. (2007). Work patterns and fatigue-related risk among junior doctors. Occupational and Environmental Medicine, 64(11), 733-738.

Gander P H
Purnell H
Garden A
Woodward A
Gander, P. H., Purnell, H., Garden, A., & Woodward, A. (2005). Work patterns of New Zealand Resident Medical Officers: implications for doctors and patients, and strategies for improvement. Wellington, New Zealand: Sleep/Wake Research Centre, Massey University.

Webster C
Merry A
Gander P H
Mann N K
Webster, C., Merry, A., Gander, P. H., & Mann, N. K. (2004). A prospective, randomised clinical evaluation of a new safety-orientated injectable drug administration system in comparison with conventional methods. Anaesthesia, 59(1), 80-87.

Millar M A
Gander P H
Millar MA and Gander PH (2002). The Timing of Anaesthetic Incidents: Examination of Time-of-Day Effects. Sleep 25: A280.

Millar M A
Gander P H
Millar MA and Gander PH (2002). Estimating the Contribution of Fatigue to Reported Anaesthesia Incidents. Sleep 25: A281.

Gander P H
Merry A
Millar M M
Weller J
Gander, P. H., Merry, A., Millar, M. M., & Weller, J. (2000). Hours of work and fatigue-related error: A survey of New Zealand anaesthetists. ANAESTHESIA AND INTENSIVE CARE, 28(2), 178-183.

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