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Measuring ‘Need for Recovery’ as an indicator of staff well-being in the emergency department: a survey study
  1. Blair Graham1,2,
  2. Laura Cottey2,3,
  3. Jason E Smith2,3,
  4. Mark Mills4,
  5. Jos M Latour1
  1. 1 Faculty of Health, University of Plymouth, Plymouth, UK
  2. 2 Emergency Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
  3. 3 Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK
  4. 4 Plymouth Peninsula Medical School, Plymouth University, Plymouth, United Kingdom
  1. Correspondence to Dr Blair Graham, Faculty of Health and Human Sciences, University of Plymouth Faculty of Health and Human Sciences, Plymouth PL4 8AA, UK; blair.graham{at}plymouth.ac.uk

Abstract

Background The Need for Recovery (NFR) Scale is an 11-item questionnaire that assesses how work affects intershift recovery. Items are summated to form a score with a maximum value of 100. Previously reported scores range from 38 in nurses to 55 in miners. This study aimed to determine the NFR Score among ED staff and to identify whether the NFR Score was associated with characteristics potentially implicated with recovery from work.

Methods Staff in a single ED in the South West of England (annual attendances of 93 000) were asked to complete an electronic questionnaire incorporating the NFR Scale plus additional items relating to demographic, work-related and well-being characteristics, in their own time during January 2018. Descriptive statistics are presented, including median NFR Scores and associations with additional characteristics. Thematic analysis of free-text comments from an open-ended question was undertaken.

Results One hundred and sixty-eight responses were obtained (80.3% capture). Median NFR Score across all staff groups was 81.8 out of 100.0 (95% CI 72.7 to 81.8). Shift duration exceeding 12 hours, dissatisfaction with work–life balance and self-reported perceptions of burnout were associated with significantly elevated NFR Scores. Themes resulting from the open-ended question were ‘barriers to intershift recovery’ and ‘coping with work’.

Conclusion The NFR Scores in this study exceeded scores reported elsewhere and were associated with some demographic, occupational and well-being characteristics. The NFR Scale has utility to measure the need for intershift recovery among ED staff. A larger study is warranted to identify specific determinants of recovery and to provide recommendations.

  • emergency department
  • staff support
  • safety
  • qualitative research
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Footnotes

  • Handling editor Mary Dawood

  • Twitter @timecritical, @lauracottey

  • Contributors BG coordinated the study design and oversight of data collection, undertook initial data analysis, contributed to the thematic analysis of free-text comments, the first draft of the manuscript and subsequent revised versions, and approved the final version for submission. LC co-coordinated study design and oversight of data collection; contributed to the data analysis, including thematic analysis of free-text comments, the first draft of the manuscript and subsequent revised versions; and approved the final version for submission. JES contributed to the development of the study design and contributed to the first draft of the manuscript and subsequent revised versions, and approved the final version for submission. MM contributed to the development of the study design, undertook the initial data collection as part of his medical student special study module and approved the final version of the manuscript for submission. JML contributed to the development of the study design and contributed to the first draft of the manuscript and subsequent revised versions, and approved the final version for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval The chair of the regional Research Ethics Committee was prospectively approached for comment on this study and confirmed formal ethical approval was not required to conduct staff survey. However, the project was registered with the Audit and Service Evaluation department at the host institution (CA_2017-18-147).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available from the study authors upon reasonable request.

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