The impact of ward climate on staff perceptions of barriers to research driven service changes on mental health wards: a cross sectional study.

To create successful change programmes for mental health wards, it is necessary to understand which aspects of ward climate prevent change.Does ward climate influence mental health nurse's perceptions of barriers to change?Random effects models were used to test whether the following ward climate variables influenced the outcome measure "staff perceptions of barriers to change" (VOCALISE) and its subscales (powerlessness /confidence/demotivation): 1.Perceptions of ward climate (VOTE: subscales included work intensity/job satisfaction/interaction anxiety). 2.Ward climate indicators (incidents/detention under the Mental Health Act (2007)/staffing/bed pressure). As known predictors of VOCALISE, burnout (Maslach Burnout Inventory) and occupational status were included in the models.Perceptions of ward climate (VOTE), incidents, temporary staff, occupational status and burnout, significantly and negatively affected perceptions of barriers to change (VOCALISE). Staff with low job satisfaction (VOTE) and high interaction anxiety (VOTE) also had low confidence (VOCALISE). Staff with low job satisfaction (VOTE) were also demotivated (VOCALISE).Ward climate is an important predictor of how staff regard service changes in mental health wards.Staff perceptions of ward climate and barriers to change should be assessed ahead of service changes to identify pressures that impede progress and lower morale.