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

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


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


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