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

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

86 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2026-10-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This prospective, monocentric observational study aims to evaluate the implementation of a Job Rotation (JR) program in the Department of Cardiovascular Sciences at Fondazione Policlinico Universitario A. Gemelli IRCCS. The primary objective is to assess the impact of JR on the development of professional and clinical nursing competencies, as well as on organizational health and burnout levels. The study involves two groups of nurses: one participating in a structured JR program with bimonthly rotations across intensive, medical, surgical, and rehabilitation units; and a control group continuing routine activities. Outcomes will be measured using validated tools, including the Italian Nurse Competence Scale - Short Form (I-NPCS-SF), the Italian Nurse Competence Scale (INCS), the Maslach Burnout Inventory - HSS, and the QISO questionnaire. The research investigates whether JR improves competency, reduces burnout, and enhances perceived organizational health.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Job Rotation (JR) is an organizational practice where employees are periodically transferred between roles, departments, or different tasks within the same organization. This approach has been adopted in various sectors to promote flexibility, foster the development of new skills, and maintain existing competencies. It also helps reduce job monotony and enhances professional engagement. In the healthcare field, particularly in nursing, JR is emerging as a promising strategy to address key challenges such as burnout, staff shortages, and the need to adapt quickly to dynamic and complex care environments.

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

See the medical conditions and disease areas that this research is targeting or investigating.

Healthy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

A two-arm, non-randomized, parallel assignment study comparing nurses participating in a structured job rotation program with nurses continuing standard work routines within a cardiovascular department.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Due to the nature of the organizational intervention, neither participants nor investigators are blinded to group assignment. Nurses are aware of their participation in the job rotation program, and data collection is conducted openly by the research team.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

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.

Group Type EXPERIMENTAL

Job Rotation Program

Intervention Type BEHAVIORAL

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.

Group Type OTHER

No Job Rotation (Standard Care)

Intervention Type BEHAVIORAL

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

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

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.

Intervention Type BEHAVIORAL

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.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Registered nurses employed in the Department of Cardiovascular Sciences at Fondazione Policlinico Universitario A. Gemelli IRCCS
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

1. Nurses with certified physical or psychological limitations that prevent participation in job rotation
2. Nurses who do not provide informed consent
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Manuela Cavalletti

Nursing Director, Principal Investigator, Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Manuela Cavalletti, MSN

Role: CONTACT

+390630153214

References

Explore related publications, articles, or registry entries linked to this study.

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.

Reference Type BACKGROUND
PMID: 34972902 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33249140 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 23495371 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19138390 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 37558253 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 38047175 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 39004602 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 26929845 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33595064 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 33326130 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 38422526 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.mindgarden.com

Maslach burnout inventory instruments and scoring guides forms. http://www.mindgarden.com

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

Prot. 0000612/25

Identifier Type: OTHER

Identifier Source: secondary_id

ID7538

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Ovice Nurse Transition Shock and Readiness
NCT07020208 NOT_YET_RECRUITING NA