The aim of this study is to evaluate the management of sudden absences of nursing staff in hospital settings. In addition, this study aims to describe nurse managers’ daily work regarding rescheduling due to sudden absences of nursing staff, from the perspectives of using a paper-based system or an IT-based rescheduling solution. The dissertation also includes an analysis of experiences of nursing staff floating.

In Phase I, a scoping review was carried out to identify the IT-based rescheduling solutions for the daily rescheduling of nursing staff in a hospital setting, and rescheduling outcomes for patients, nursing staff and originations. In Phase II, a developed IT-based rescheduling solution was implemented at one university hospital department and a quasi-experimental pre- and post-test design was used to evaluate the nurse managers’ (n=17) work tasks with the Rescheduling Task Survey (RTS) during the rescheduling process of nursing staff. The quasi-experimental pre- and post-test design was repeated with a large sample of nurse managers (n=61), and the duration of the rescheduling process was observed. The usability of the IT-based rescheduling solution was evaluated with the System Usability Scale (SUS). In Phase III, the associations between stress, psychosocial factors and floating experience among nursing staff (n=1336) was evaluated, and the experiences nursing staff (n=747) with floating shifts during the past year were described.

There is limited research on IT-based rescheduling staffing solutions and their outcomes for nursing staff, organizations and patients. Before and after implementation, the IT-based rescheduling solution nurse managers reported a total of 2,612 sudden absences with 5,800 rescheduling tasks such as phone calls and conversations. The main reason for sudden absence was unplanned sick leave (79%). After the implementation of the IT-based rescheduling solution, nurse managers’ rescheduling tasks, unstaffed and unplanned shift changes, the use of float pool nurses and floating nurses increased significantly. The implementation of the IT-based rescheduling process also revealed significant cost saving opportunities for hospitals. During this study’s short follow-up period, altogether €31,878 was saved with the use of floating nurses to cover sudden absences. There are no previous studies investigating floating and its association with stress among nursing staff. In this study, reported experience of stress did not differ significantly between participants with or without floating experience. However, there are factors related to floating that increase stress among nurses. Nurse managers need to ensure clear instructions for floating shifts on their units and that those instructions are followed.