Project finds simple ways to improve the well-being of paediatric critical care staff

The Staff Well-being (SWell) project has developed two simple, easy-to-deliver sessions to improve the well-being of staff in paediatric critical care (PCC) units in UK hospitals.

PCC staff are known to experience high levels of moral distress, symptoms of post-traumatic stress disorder (PTSD) and burnout, but often feel little is offered to help them with their mental health. The SWell team at Aston University, led by Professor Rachel Shaw from the Institute of Health and Neurodevelopment, realised following a literature review that there are no existing, evidence-based interventions specifically designed to improve PCC staff well-being. Initial work by SWell identified the “active ingredients” likely to create successful intervention designs.

Together with a team from NHS England, the Aston University researchers set up the SWell Collaborative Project: Interventions for Staff Well-being in Paediatric Critical Care, in PCC units across England and Scotland. The aim of the project was to determine the feasibility and acceptability of implementing well-being interventions for staff working in PCC in UK hospitals. In total, 14 of the 28 UK PCC units were involved. One hundred and four intervention sessions were run, attended by 573 individuals.

The research is published in the journal Nursing in Critical Care. Professor Shaw said, “The significance of health care staff well-being was brought to the surface during the COVID-19 pandemic, but it’s a problem that has existed far longer than that. As far as we could see, researchers had focused on measuring the extent of the problem rather than coming up with possible solutions.

“The SWell project was initiated to understand the challenges to well-being when working in paediatric critical care, to determine what staff in that high-pressure environment need, and what could actually work day-to-day to make a difference. Seeing PCC staff across half the paediatric critical care units in the UK show such enthusiasm and commitment to making the SWell interventions a success has been one of the proudest experiences in my academic career to date.”

The two well-being sessions tested are low-resource and low-intensity, and can be delivered by staff for staff without any specialist qualifications.

In the session “Well-being Images,” a small group of staff is shown images representing well-being, with a facilitated discussion using appreciative inquiry—a way of structuring discussions to create positive change in a system or situation by focusing on what works well, rather than what is wrong.

In the “Mad-Sad-Glad” session, another small group reflective session, participants explore what makes them feel mad, sad and glad, and identify positive actions to resolve any issues raised.

The key ingredients in both sessions are social support—providing a psychologically safe space where staff can share their sensitive experiences and emotions without judgement, providing support for each other; self-belief—boosting staff’s self-confidence and ability to identify and express their emotions in response to work; and feedback and monitoring—encouraging staff to monitor what increases their stress, when they experience challenging emotions, and what might help boost their well-being in those scenarios.

Feedback from staff both running and participating in the SWell interventions was very positive, with high satisfaction and feasibility ratings. Participants like that the session facilitated open and honest discussions, provided opportunities to connect with colleagues and offered opportunities for generating solutions and support.

One hospital staff member responsible for delivering the sessions said, “Our staff engaged really well, and it created a buzz around the unit with members of the team asking if they could be ‘swelled’ on shift. A really positive experience and we are keeping it as part of our staff well-being package.”

The team concluded that even on busy PCC units, it is feasible to deliver SWell sessions. In addition, following the sessions, staff well-being and depression scores improved, indicating their likely positive impact on staff. Further evaluations are needed to determine whether positive changes can be sustained over time following the SWell sessions.

Donna Austin, an advanced critical care practitioner at University Hospital Southampton paediatric intensive care unit, said, “We were relatively new to implementing well-being initiatives, but we recognised the need for measures to be put in place for an improvement in staff well-being, as staff had described burnout, stress and poor mood.

“SWell has enabled our unit to become more acutely aware of the needs of the workforce and adapt what we deliver to suit the needs of the staff where possible. Staff morale and retention have been the greatest outcomes from us participating in the SWell study and ongoing SWell related interventions.”

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UK | April 2026 | FA-11628072