Implementation of Job Rotation for the Development of Nursing Competencies and the Improvement of Organizational Health in a Department of Cardiovascular Sciences: A Research Protocol
NCT ID: NCT06987487
Last Updated: 2025-09-08
Study Results
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Basic Information
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NOT_YET_RECRUITING
NA
86 participants
INTERVENTIONAL
2025-10-01
2026-10-01
Brief Summary
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Detailed Description
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In specialized areas such as cardiology, which includes intensive care, medical-surgical units, and cardiac rehabilitation, JR can support the development of transversal competencies in emergency management, the use of advanced technologies, and interprofessional collaboration. The alternating roles allow nurses to gain practical skills and a comprehensive understanding of the patient care pathway, ultimately improving care quality and emergency responsiveness.
Implementing a JR protocol in a Department of Cardiovascular Sciences may foster a more flexible and competent nursing workforce and promote a collaborative and resilient work environment. Periodic transfers between specialized areas may help nurses broaden their competencies, better adapt to workload variations, and improve both operational efficiency and job satisfaction. JR could also enhance team cohesion and mutual support, reducing long-term adverse events and improving care quality.
Primary Objective To assess the impact of Job Rotation (JR) in the Department of Cardiovascular Sciences on nursing professional and clinical competencies, organizational health, and burnout levels.
Secondary Objectives To evaluate the effectiveness of JR in maintaining or improving professional and clinical nursing competencies.
To measure differences in mean competency scores between JR and non-JR nurses. To analyze the relationship between the number of JR cycles completed and competency levels.
To assess the impact of JR on organizational health and nurse burnout.
Primary Endpoint Difference in professional and clinical competency levels across specialized units (cardiac intensive care, cardiac surgery ICU, medical, surgical, and cardiac rehabilitation units) between JR and non-JR groups, using the Italian Nurse Competence Scale - Short Form (I-NPCS-SF).
Secondary Endpoints Mean job satisfaction score among nurses. Differences in burnout levels (Maslach Burnout Inventory - Human Services Survey) between JR and non-JR groups.
Differences in perceived organizational health (QISO) between JR and non-JR groups.
Relationship between the number of JR cycles and clinical competency scores.
Hypotheses H1: JR improves professional and clinical nursing competencies. H2: JR nurses achieve higher competency scores than non-JR nurses. H3: Nurses completing more JR cycles show greater competency improvement. H4: JR enhances organizational health. H5: JR reduces nurse burnout.
Methods
Design:
Prospective, single-center, observational study without drugs or medical devices.
Duration: 12 months from ethics approval and administrative clearance until data saturation.
Setting: Fondazione Policlinico Universitario A. Gemelli IRCCS - Department of Cardiovascular Sciences.
This study will involve the following units:
Cardiovascular Rehabilitation (7M) Coronary Intensive Care Unit (8C) Cardiac Anesthesia and Intensive Care (8N) Cardiology and Electrophysiology (8L) Internal Cardiovascular Medicine and Heart Failure (8M) Cardiac Surgery (8P) Vascular Surgery and Cardiology (9L)
Conceptual Framework Based on the preliminary literature review, JR appears to have a positive impact on the development of clinical nursing competencies, improving job satisfaction and organizational health while reducing perceived burnout. The conceptual model illustrates the relationships among study variables.
Intervention The JR program involves bimonthly rotations. One nurse from each unit will be transferred to another participating unit. At the end of each cycle, the nurse returns to their original unit, and a new nurse begins rotation. This cyclic mechanism continues throughout the study duration.
Training needs will be identified by the Principal Investigator with support from unit coordinators. A tutor may be assigned if needed. Training will follow the hospital's standard operational instruction for onboarding.
Data Collection Procedure Pre-intervention: All tools will be administered to both intervention and control groups.
Post-intervention: Final assessment will be administered to the intervention group to evaluate changes in competencies, satisfaction, burnout, and organizational health.
Sample Size and Statistical Analysis Sample size was calculated using G\*Power with a significance level of 0.05, power of 0.9, and effect size of 0.5, resulting in a required sample of 86 participants (43 per group).
Data analysis will include:
Descriptive statistics: frequencies, percentages, means ± SDs or medians with IQRs.
Normality testing using skewness, kurtosis, and Shapiro-Wilk test. Between-group comparisons: Student's t-test (for normal data), Mann-Whitney U test (for non-normal data), chi-square or Fisher's exact test (for categorical data).
Within-group comparisons (JR group pre/post): paired t-test or Wilcoxon test. Repeated measures analysis: ANOVA or Kruskal-Wallis test, depending on distribution.
Correlation analysis: Pearson or Spearman, based on data distribution. Significance threshold set at p \< 0.05. Analyses will be conducted using SPSS and R.
Safety and Adverse Event Management The JR program will be structured to ensure nurse and patient safety during transitions. Pre-rotation training will cover safety protocols, technologies, and emergency procedures. A peer tutor will support each nurse during initial integration. Continuous monitoring of safety and performance will be conducted. Adverse events will be reported through the hospital's incident reporting system, and corrective actions will be taken as needed.
Expected Results JR is expected to enhance nurses' clinical and professional competencies, reduce burnout, and improve organizational health and job satisfaction. By fostering cross-unit collaboration, JR may also contribute to greater cohesion, lower absenteeism, and better workload management. The intervention may support a more adaptable and efficient workforce, ultimately improving care quality and clinical outcomes.
Coercion and Undue Influence Risk Mitigation The study complies with internal policies to safeguard employee rights, including informed decision-making and freedom from coercion or negative professional consequences. Adequate time and support will be given to participants before consent is obtained.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Job Rotation Group
Nurses in this group will participate in a structured job rotation program involving bimonthly rotations across various units in the Department of Cardiovascular Sciences, including intensive care, medical, surgical, and rehabilitation units. The intervention aims to enhance clinical and professional competencies, organizational health, and reduce burnout.
Job Rotation Program
Nurses assigned to the intervention group will participate in a structured job rotation program across multiple cardiovascular units (e.g., intensive care, medical, surgical, rehabilitation) every two months for a period of 12 months. Each rotation cycle involves temporary reassignment to a different unit, followed by a return to the original unit. Each nurse will undergo orientation and receive support from a dedicated tutor in the host unit.
No Job Rotation
Nurses in this group will continue performing their usual clinical duties in their original units, without participating in the job rotation program. This group will be used as a comparator to assess the effects of the intervention.
No Job Rotation (Standard Care)
Nurses in the control group will continue their usual duties in their respective units without participating in the job rotation program. They will be exposed to the same data collection tools as the intervention group, but without any planned rotation or inter-unit movement.
Interventions
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Job Rotation Program
Nurses assigned to the intervention group will participate in a structured job rotation program across multiple cardiovascular units (e.g., intensive care, medical, surgical, rehabilitation) every two months for a period of 12 months. Each rotation cycle involves temporary reassignment to a different unit, followed by a return to the original unit. Each nurse will undergo orientation and receive support from a dedicated tutor in the host unit.
No Job Rotation (Standard Care)
Nurses in the control group will continue their usual duties in their respective units without participating in the job rotation program. They will be exposed to the same data collection tools as the intervention group, but without any planned rotation or inter-unit movement.
Eligibility Criteria
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Inclusion Criteria
2. Willing and able to provide written informed consent
3. Willing to participate in the job rotation program or remain in their original unit, depending on group assignment
Exclusion Criteria
2. Nurses who do not provide informed consent
ALL
Yes
Sponsors
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Fondazione Policlinico Universitario Agostino Gemelli IRCCS
OTHER
Responsible Party
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Manuela Cavalletti
Nursing Director, Principal Investigator, Dr.
Central Contacts
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References
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Platis C, Ilonidou C, Stergiannis P, Ganas A, Intas G. The Job Rotation of Nursing Staff and Its Effects on Nurses' Satisfaction and Occupational Engagement. Adv Exp Med Biol. 2021;1337:159-168. doi: 10.1007/978-3-030-78771-4_18.
Liang HY, Tang FI, Wang TF, Yu S. Evaluation of Nurse Practitioners' Professional Competence and Comparison of Assessments Using Multiple Methods: Self-Assessment, Peer Assessment, and Supervisor Assessment. Asian Nurs Res (Korean Soc Nurs Sci). 2021 Feb;15(1):30-36. doi: 10.1016/j.anr.2020.10.004. Epub 2020 Nov 26.
Kim HY. Statistical notes for clinical researchers: assessing normal distribution (2) using skewness and kurtosis. Restor Dent Endod. 2013 Feb;38(1):52-4. doi: 10.5395/rde.2013.38.1.52. Epub 2013 Feb 26. No abstract available.
Ho WH, Chang CS, Shih YL, Liang RD. Effects of job rotation and role stress among nurses on job satisfaction and organizational commitment. BMC Health Serv Res. 2009 Jan 12;9:8. doi: 10.1186/1472-6963-9-8.
Emanuela P, Alessandro S, Florian S, Gennaro R, Ina D, Rosario C, Ippolito N. Psychometric Validation of the Nursing Professional Competence Scale Among Italian Nurses and Albanian Nursing Students. J Nurs Meas. 2023 Nov 29;31(4):595-605. doi: 10.1891/JNM-2021-0060.
Chatterjee S, Shah A, Sharma R, Wadhwa M. Effect of Job Rotation Concept for Nursing Staff with Special Reference to Private Based Hospital, Vadodara. Indian J Occup Environ Med. 2023 Jul-Sep;27(3):197-204. doi: 10.4103/ijoem.ijoem_354_21. Epub 2023 Oct 6.
Celikturk Doruker N, Demir Korkmaz F. Investigation of burnout and quality of work life of cardiac surgery nurses: A cross-sectional study. Nurs Crit Care. 2024 Nov;29(6):1373-1384. doi: 10.1111/nicc.13124. Epub 2024 Jul 14.
Ioannou P, Katsikavali V, Galanis P, Velonakis E, Papadatou D, Sourtzi P. Impact of Job Satisfaction on Greek Nurses' Health-Related Quality of Life. Saf Health Work. 2015 Dec;6(4):324-8. doi: 10.1016/j.shaw.2015.07.010. Epub 2015 Aug 20.
Bagnasco A, Barisone M, Aleo G, Watson R, Catania G, Zanini M, Thompson DR, Sasso L. An international e-Delphi study to identify core competencies for Italian cardiac nurses. Eur J Cardiovasc Nurs. 2021 Oct 27;20(7):684-691. doi: 10.1093/eurjcn/zvab003.
Alfuqaha OA, Al-Hairy SS, Al-Hemsi HA, Sabbah AA, Faraj KN, Assaf EM. Job rotation approach in nursing profession. Scand J Caring Sci. 2021 Jun;35(2):659-667. doi: 10.1111/scs.12947. Epub 2020 Dec 16.
Alexandrou M, Simsek B, Rempakos A, Kostantinis S, Karacsonyi J, Rangan BV, Mastrodemos OC, Allana SS, Rao SV, Linzer M, Egred M, Milkas A, Sandoval Y, Burke MN, Brilakis ES. Burnout in cardiology: a narrative review. J Invasive Cardiol. 2024 May;36(5). doi: 10.25270/jic/23.00292.
Related Links
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Maslach burnout inventory instruments and scoring guides forms. http://www.mindgarden.com
Other Identifiers
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Prot. 0000612/25
Identifier Type: OTHER
Identifier Source: secondary_id
ID7538
Identifier Type: -
Identifier Source: org_study_id
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