E-learning to enhance workplace wellness in healthcare staff and students. Emily Gartshore
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1 E-learning to enhance workplace wellness in healthcare staff and students Emily Gartshore
2 Background University of Nottingham (2014) Masters Dissertation: Development and evaluation of a workplace wellness e-learning tool for healthcare staff and students Project and findings Burdett Trust (2015) funded project: Supporting health and wellbeing in nurses and midwives using and online intervention Initial stakeholder consultation interviews and scoping event stand
3 Workplace wellness e-learning tool Development (RLO-CETL, 2009) Evidence based, key workplace health topics Peer review by 14 experts in health and wellbeing Pilot study and user evaluation Method Quantitative experimental one-group pre and posttest method Multiple choice questionnaire Pre and post workplace wellness knowledge Evaluation of usability
4 Results Participants: 188 users (93.1% female, age 18-60) completed online knowledge questionnaires before (n=188) and after (n=88) exposure to learning tool 53.7% employed, 69.1% higher education student (22.8% were both employees and registered healthcare students) Pre-questionnaire: Mean response accuracy (47.6%, 9.52/20) revealed under 50% accuracy for participants at the outset ANOVA testing revealed no statistically significant relationship between pre-questionnaire score and demographic characteristics
5 Results Post-questionnaire: A statistically significant improvement in mean accuracy from 47.6% (9.52/20) to 77.5% (15.5/20). 1.7 effect size. Question specific analysis: A shift in correct responses from 1/20 questions to 14/20 questions achieving over 75% correct responses
6 Discussion Highlighted a need to improve workplace wellness knowledge in healthcare staff and students Study and literature reflects potential of e-learning to improve knowledge whilst being; Accessible and flexible User friendly Independent learning (Cheong Li et al, 2015; Clark and Mayer, 2011) Limitations: Response rate, voluntary response bias (computer competence, knowledge score) Dissemination: Local trust (14,000 staff) and UoN database: freely available in over 50 countries.
7 Supporting health and wellbeing in NHS nurses and midwives The Burdett Trust for Nursing (2015) Online intervention to promote health and wellbeing in NHS nurses and midwives January Stakeholder consultation with nurses, midwives and students Invitation to participate via Interviews Event Stand at Nursing and Midwifery event and Band 7 time out day
8 Stakeholder consultation Participants interviewed: 12 nurses (Practice development, PICU, Paeds Gastro, Surgical Admissions, Oncology) 3 student nurses (Year 1 and Year 3) 1 student midwife (Year 2) Event stand participation: Nursing and Midwifery event- 96 nurses and midwives. 84 nurses/ 12 midwives. Band 2-7 Band 7 time out day- 220 senior nurses and midwives. Band 7 and 8. To be interviewed: 3 midwives (Labour suite/ ward)
9 Key themes All interviewed felt health and wellbeing was essential for care they provided, with impact on compassion, role modeling, documentation and patient safety If you don t feel bright and well in yourself, you don t feel like you are giving good care, its hard to be caring and empathetic. (Nurse 2) If I am not being healthy then I am just being hypocritical when I promote health to my patients. (Nurse 5) I feel that is I am being a positive role model, being healthy and active, I am representing health care in the right way. (Student Nurse 1)
10 Key themes I rush to get home, like I rush my writing and stuff, because I am so tired by the end of the day that I don t feel like I want to stay behind and do my best with paperwork. There is nothing you can do at that point, because you are just too tired. (Nurse 10) Nurses health is so important, cause you are giving dangerous drugs, in large quantities and you need to do this safely. You have got to concentrate, you cannot do that with your stomach grumbling and your legs crossed. (Band 7 time out day)
11 Key themes Time- protected breaks, leaving on time, nutrition and hydration, workload Not enough hours to achieve everything, it s emotionally draining. (Nurse 3) It s challenging, working through breaks to get home on time, but not achieving that either. (N&M event) Sometimes on the ward, even just getting a drink is a god send actually. And sometimes you are holding your bladder for so long that it hurts. (Nurse 5) I genuinely cannot count the number of times that I have missed my breaks, because I am busy, I m running late, I ve got loads of writing to do. (Nurse 6)
12 Key themes Shift working- 12 hours shifts, night shifts and transition between nights and days. Night shifts especially. I think my, that change in my body clock really upsets my eating habits, my eating patterns. My ability to go to the gym if I wanted to. I think that to myself it would always lower my mood too. (Nurse 1) No consistency with rota patterns, only staff with children get set rotas or shifts. I find I am finishing nights on Saturday morning and being on a long day Sunday. There is no time to recover. (N&M event) Its hard to be healthy with long working days, over 12 hours. You end up working much more hours than you are paid for, with no time for your life, let alone being healthy. (N&M event)
13 Challenges for students Achieving work-life balance- ability to balance commitments of placement, university and home life. My biggest problem is getting a balance. As a student nurse I am neglecting my family. I go to placement, when I get home my kids are in bed, on my day off I go to the library to do my assignments. The list never ends cause I have to do part time work too, and all the jobs are still there Making lunch boxes, sorting dinner, cleaning. (Student nurse 2) Mentors don t understand it. When they go home after a long day, they can relax, I go home to 3 assignments, my portfolio and reflections. I find it hard to sleep, and the last thing I want to do is prepare lunch for the next long day. (Student midwife 1)
14 Challenges for students I struggle to take care of myself. Keeping on top of assignments, lectures and placement is really hard. I feel tired and stressed, which makes it harder to concentrate and then I feel even more tired and stressed. It, well I think it has a big impact on my learning. I wish I had known how to manage my time better. Time management is the hardest part.
15 Workplace health education Quantitative workplace wellness e-learning study- Knowledge of workplace health found to be poor (47.6% accuracy) at baseline for healthcare staff and students E-learning shows potential to improve knowledge of workplace health Qualitative stakeholder consultation- Challenges for achieving workplace health and wellbeing in nurses and midwives: Key themes: time, breaks, shift patterns, nights Different theme seen through student nurses and student midwife interview: Achieving work life balance Managing commitments of placements, university and home life
16 Moving forward Burdett study- Developing an online intervention to promote health and wellbeing in nurses and midwives- focusing on key themes National call to improve health and wellbeing in healthcare staff with implications for patient outcomes and satisfaction, staff engagement, compassion and role models for health. (Blake and Harrison, 2013; Point of Care Foundation, 2014; West et al, 2011; Boorman, 2009). Stakeholder consultation has further highlighted the need for nurses and midwives, but also student nurses and midwives to achieve health and wellbeing. If we educate and support student nurses and midwives to achieve health and wellbeing during placements, prepare them with right skills for qualifying as future workforce Blended learning approaches to healthcare student education has shown success (Lahti et al, 2014). Potential for online intervention for student health and wellbeing
17 Questions? Emily Gartshore- Staff Nurse, Nottingham University Hospitals NHS Trust Research Associate- University of Nottingham, School of Health Sciences Tweet me
18 References Black, C. And Frost (2011). Health at work an independent review of sickness absence (Cm8205). London: The Stationary Office. Blake, H. (2010). Computer-Based Learning Objects in Healthcare: The Student Experience. International Journal of Nursing Education Scholarship 7(1): Blake, H. and Harrison, C, (2013). Health behaviours and attitudes towards being role models. British Journal of Nursing 22 (2): pp Centre for Excellence in Teaching and Learning in Reusable Learning Objects (RLO-CETL) (2009) CETL Agile Development Workflow. Available online at: (Accessed ). Cheong Li, K., Wong, T. and Cheung, S. (2015) Technology in Education: International Conference, ICTE 2014, Hong Kong, China, July 2-4, Revised Selected Papers (Communications in Computer and Information Science). UK: Springer. Clark, R. and Mayer, R. (2011) e-learning and the Science of Instruction: Proven Guidelines for Consumers and Designers of Multimedia Learning (Essential Knowledge Resource). New York: John Wiley & Sons Inc. Department of Health (DH) (2011a). Healthy Staff, Better Care for Patients Realignment of Occupational Health Services to the NHS in England. Available online at: (Accessed: ). Department of Health (DH) (2011b). Framework for Technology Enhanced Learning. Available online at: (Accessed: ). Lahti, M., Hatonen, H. and Valimaki, M. (2014). Impact of e-learning on nurses' and student nurses knowledge, skills, and satisfaction: A systematic review and meta-analysis. International journal of nursing studies 51(1): Musich, S., Schubiner, H., and McDonald, T. (2009). Keeping healthy workers healthy: creating a culture of health. In N. P. Pronk (Ed.), ACSM s worksite health handbook: a guide to building healthy and productive companies (2nd ed). Champaign, IL (USA): Human Kinetics Publishers. NHS (2014), Five Year Forward View. Available online at: (Accessed ). National Information Board (NIB) (2014). Personalised Health and Care 2020 Using Data and Technology to Transform Outcomes for Patients and Citizens A Framework for Action. London: HM Government. The Point of Care Foundation (2014). Staff Care: how to engage staff in the NHS and why it matters. London: The Point of Care Foundation. World Health Organisation (WHO) (2011). Global status report on noncommunicable diseases Geneva: WHO.
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