MPhil; MPharm; BMedSci (USYD)
Sofia is a registered pharmacist with experience in clinical, educational and research settings. Sofia has worked on a number of ARC and NHMRC projects. She has experience in quantitative and qualitative analysis methods, as well as recruiting and educating health care professionals as part of their continuing professional development. Sofia is currently involved in health services research at the Centre for Health Services Management.
Roche, M.A., Duffield, C., Friedman, S., Dimitrelis, S. & Rowbotham, S. 2016, 'Regulated and Unregulated Nurses in the Acute Hospital Setting: Tasks Performed, Delayed or Not Completed', Journal of Clinical Nursing, vol. 25, no. 1-2, pp. 153-162.View/Download from: UTS OPUS or Publisher's site
Roche, M.A., Duffield, C.M., Friedman, S., Twigg, D., Dimitrelis, S. & Rowbotham, S. 2016, 'Changes to nurses' practice environment over time.', Journal of Nursing Management, vol. 24, no. 5, pp. 666-675.View/Download from: UTS OPUS or Publisher's site
Duffield, C., Graham, E., Donoghue, J., Griffiths, R., Bichel-Findlay, J. & Dimitrelis, S. 2015, 'Why older nurses leave the workforce and the implications of them staying.', Journal of Clinical Nursing, vol. 24, no. 5-6, pp. 824-831.View/Download from: UTS OPUS or Publisher's site
To identify factors that motivate older nurses to leave the workforce.As many older nurses are now reaching retirement age and will be eligible for government-funded pensions, governments are concerned about the impending financial burden. To prepare for this scenario, many are looking at increasing the age of retirement to 67 or 70 years. Little is known about how this will affect the continuing employment of older nurses and the consequences for employers and the nurses themselves if they remain longer in the workforce.Prospective randomised quantitative survey study.The Mature Age Workers Questionnaire, Job Descriptive Index and Job in General Scale were used to measure job satisfaction, intention to retire and factors encouraging retirement in registered nurses aged 45 years and over (n = 352) in Australia (July-August 2007).There were 319 respondents. The mean age proposed for leaving the workforce was 617 years. Key motivators were: financial considerations (401%), primarily financial security; nurse health (174%) and retirement age of partner (133%).Older nurses are leaving the workforce prior to retirement or pension age, primarily for financial, social and health reasons, taking with them significant experience and knowledge. As financial considerations are important in older nurses decisions to continue to work, increasing the age of retirement may retain them. However, consideration will need to be given to ensure that they continue to experience job satisfaction and are physically and mentally able to undertake demanding work.Increasing retirement age may retain older nurses in the workforce, however, the impact on the health of older nurses is not known, nor is the impact for employers of older nurses continuing to work known. Employers must facilitate workplace changes to accommodate older nurses.
Duffield, C., Graham, E., Donoghue, J., Griffiths, R., Bichel-Findlay, J. & Dimitrelis, S. 2015, 'Workforce shortages and retention of older nurses.', Australian nursing & midwifery journal, vol. 22, no. 7, pp. 18-19.
Duffield, C.M., Roche, M.A., Dimitrelis, S., Homer, C. & Buchan, J. 2015, 'Instability in patient and nurse characteristics, unit complexity and patient and system outcomes.', Journal of Advanced Nursing, vol. 71, no. 6, pp. 1288-1298.View/Download from: UTS OPUS or Publisher's site
AIMS: To explore key factors related to nursing unit instability, complexity and patient and system outcomes. BACKGROUND: The relationship between nurse staffing and quality of patient outcomes is well known. The nursing unit is an important but different aspect that links to complexity and to system and patient outcomes. The relationship between the instability, complexity and outcomes needs further exploration. DESIGN: Descriptive. METHODS: Data were collected via a nurse survey, unit profile and review of patient records on 62 nursing units (wards) across three states of Australia between 2008-2010. Two units with contrasting levels of patient and nurse instability and negative system and patient outcomes, were profiled in detail from the larger sample. RESULTS: Ward A presented with greater patient stability (low occupancy, high planned admissions, few ICU transfers, fewer changes to patient acuity/work re-sequencing) and greater nurse instability (nurses changing units, fewer full-time staff, more temporary/casual staff) impacting system outcomes negatively (high staff turnover). In contrast, Ward B had greater patient instability, however, more nurse stability (greater experienced and permanent staff, fewer casuals), resulting in high rates for falls, medication errors and other adverse patient outcomes with lower rates for system outcomes (lower intention to leave). CONCLUSION: Instability in patient and nurse factors can contribute to ward complexity with potentially negative patient outcomes. The findings highlight the variation of many aspects of the system where nurses work and the importance of nursing unit managers and senior nurse executives in managing ward complexity.
Roche, M.A., Duffield, C., Dimitrelis, S. & Frew, B. 2015, 'Leadership skills for nursing unit managers to decrease intention to leave', Nursing: Research and Reviews, vol. 5, pp. 57-64.View/Download from: UTS OPUS or Publisher's site
Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals.
Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment.
Methods: Data were collected from 62 medical, surgical, and mixed units across eleven public acute care hospitals in three Australian states (September 2008 to August 2010). A total of 1,673 nurses completed a nurse survey that included measures of intention to leave and leadership aspects of the practice environment. Analyses explored specific leadership characteristics that were associated with turnover intent.
Results: The role of nursing unit managers was confirmed to be a major factor in nurses' intention to remain or leave their current workplace. Nurses valued 'human skills more highly than other leadership characteristics, including their manager's connection with nurses' concerns, clarity, participation in decisions, and encouragement.
Conclusion: Strong leadership qualities in the nursing unit manager have been associated with greater job satisfaction, reduced turnover intention among nursing staff, and improved patient outcomes. Nurse leaders need to be supported in an effort to retain nurses given ongoing workforce issues and to ensure high-quality patient care.
Roche, M.A., Duffield, C.M., Homer, C.S., Buchan, J. & Dimitrelis, S. 2015, 'The Rate and Cost of Nurse Turnover in Australia', Collegian, vol. 22, no. 4, pp. 353-358.View/Download from: UTS OPUS or Publisher's site
Nurse turnover is a critical issue facing workforce planners across the globe, partic- ularly in light of protracted and continuing workforce shortages. An ageing population coupled with the rise in complex and chronic diseases, have contributed to increased demands placed on the health system and importantly, nurses who themselves are ageing. Costs associated with nurse turnover are attracting more attention; however, existing measurements of turnover show inconsistent findings, which can be attributed to differences in study design, metrics used to calculate turnover and variations in definitions for turnover. This paper will report the rates and costs of nurse turnover across three States in Australia.
Scott, A., Witt J, Duffield, C.M. & Kalb G 2015, 'What do nurses and midwives value about their jobs? Results from a discrete choice experiment', Journal of Health Services Research and Policy, vol. 20, no. 1, pp. 31-38.View/Download from: Publisher's site
Objectives: To examine nurses' and midwives' preferences for the characteristics of their jobs.
Methods: A discrete choice experiment of 990 nurses and midwives administered as part of a survey of nurses and
midwives in Victoria, Australia.
Results: Autonomy, working hours, and processes to deal with violence and bullying were valued most highly. Nurses
and midwives would be willing to forgo 19% and 16% of their annual income for adequate autonomy and adequate
processes to deal with violence and bullying, compared to poor autonomy and poor processes for violence and bullying.
They would need to be paid an additional 24% to increase their working hours by 10% ($73 per hour). Job characteristics
that were less important were shift work, nurse to patient ratios, and public or private sector work.
Conclusions: Policies to improve retention and job satisfaction of nurses and midwives should initially focus on
autonomy, processes to deal with violence and bullying, and reasonable working hours. Further research on the costeffectiveness
of these different policies is needed.
Duffield, C.M., Roche, M.A., Homer, C.S., Buchan, J. & Dimitrelis, S. 2014, 'A comparative review of nurse turnover rates and costs across countries', Journal of Advanced Nursing, vol. 70, no. 12, pp. 2703-2712.View/Download from: UTS OPUS or Publisher's site
Measuring and comparing the costs and rates of turnover is difficult because of differences in definitions and methodologies. A comparative review of turnover data was conducted using four studies that employed the original Nursing Turnover Cost Calculation Methodology. A significant proportion of turnover costs are attributed to temporary replacement, highlighting the importance of nurse retention.
Duffield, C.M., Twigg, D., Pugh, J., Evans, G., Dimitrelis, S. & Roche, M.A. 2014, 'The Use of Unregulated Staff: Time for Regulation?', Policy Politics and Nursing Practice, vol. 15, no. 1-2, pp. 42-48.View/Download from: UTS OPUS or Publisher's site
Internationally, shortages in the nursing workforce, escalating patient demands, and financial constraints within the health system have led to the growth of unlicensed nursing support workers. Recently, in relation to the largest publicly funded health system (National Health Service), it was reported that extensive substitution of registered nurses with unskilled nursing support workers resulted in inadequate patient care, increased morbidity and mortality rates, and negative nurse outcomes. We argue that it is timely to consider regulation of nursing support workers with their role and scope of practice clearly defined. Further, the addition of these workers in a complementary model of care (rather than substitutive model) should also be explored in future research, in terms of impact on patient and nurse outcomes.