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.
Registered nurses employed in the Department of Cardiovascular Sciences at Fondazione Policlinico Universitario A. Gemelli IRCCS
Willing and able to provide written informed consent
Willing to participate in the job rotation program or remain in their original unit, depending on group assignment
Nurses with certified physical or psychological limitations that prevent participation in job rotation
Nurses who do not provide informed consent
Parallel
Job Rotation Program
BehavioralNurses 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)
BehavioralNurses 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.
Change in clinical and professional nursing competence
Competence will be assessed using the Italian Nurse Competence Scale - Short Form (I-NPCS-SF). All participants (JR and control groups) will complete the assessment at baseline (T0). Only the Job Rotation (JR) group will complete a second assessment after the rotation period (T1, 2 months). The higher the overall I-NPCS-SF score (%), the higher the clinical and/or professional competencies.
Change in job satisfaction
Job satisfaction will be assessed using the QISO questionnaire (Nursing Questionnaire on Organizational Health), which specifically addresses this construct. The measure will be collected at baseline (T0) in both groups and at T1 (2 months) in the JR group only. The questionnaire consists of 118 items designed to explore 14 theoretical dimensions of organizational well-being and three groups of indicators (positive, negative, and psychophysical distress) within the nursing population. Except for the first and last sections-dedicated to collecting sociodemographic data and open-ended responses-the items use a 4-point Likert scale ranging from "never"/"insufficient" (score 1) to "often"/"good" (score 4). Higher scores indicate better organizational health. A cutoff score of 2.6 is used to assess overall organizational well-being and to determine the presence or absence of specific workplace phenomena across the different dimensions.
Change in burnout levels
Burnout will be measured using the Maslach Burnout Inventory (MBI) - Human Services Survey (HSS). Both groups will be assessed at T0; only the JR group will be reassessed at T1. The MBI-HSS yields three distinct scores, each corresponding to a core dimension of burnout: Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA). High levels of burnout are typically indicated by elevated scores in EE and DP combined with a low score in PA. Each score is interpreted based on its position within the normative distribution: values in the upper third are classified as high, those in the middle third as moderate, and those in the lower third as low.
Change in perceived organizational health
Organizational health will be measured using the QISO questionnaire (Nursing Questionnaire on Organizational Health), which specifically addresses this construct. All participants will be assessed at T0 (baseline); only the JR group at T1 (after 2 months). The questionnaire consists of 118 items designed to explore 14 theoretical dimensions of organizational well-being and three groups of indicators (positive, negative, and psychophysical distress) within the nursing population. Except for the first and last sections-dedicated to collecting sociodemographic data and open-ended responses-the items use a 4-point Likert scale ranging from "never"/"insufficient" (score 1) to "often"/"good" (score 4). Higher scores indicate better organizational health. A cutoff score of 2.6 is used to assess overall organizational well-being and to determine the presence or absence of specific workplace phenomena across the different dimensions.
Association between number of completed rotation cycles and competence scores (JR group only)
The number of completed job rotation cycles-treated as a continuous independent variable-will be analyzed to assess its association with clinical and professional competence scores. Each nurse may complete more than one rotation during the intervention period. Competence will be measured at the end of each cycle.
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