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Professor Christine Duffield

Professor of Nursing and Health Services Management

Contact Information Email:, Campus: Joondalup,
Staff Member Details
Campus: Joondalup  


Christine is the Professor of Nursing and Health Services Management in the School of Nursing and Midwifery.


Christine completed her doctoral education at the University of New South Wales where she also completed a Master of Health Planning. She graduated from the University of Western Ontario with a Bachelor of Science in Nursing.  Prior to her appointment to her academic positions she worked for several years as a clinical nurse, educator and manager in a variety of acute care hospitals in Canada, Australia, New Zealand and the United Kingdom.

Christine's research has focused on issues associated with nurses and their work and a range of current issues facing the nursing workforce. She led the first study in Australia which examined the relationship between nursing numbers, the mix of staff and patient and staff outcomes. Other funded research projects include defining advanced practice in a range of clinical facilities, the impact of adding nursing support workers, the costs and consequences of nursing turnover, factors impacting on nurses’ health and the role of nurse managers and leaders in ensuring positive patient and staff outcomes. She has been at the forefront of ensuring the translation of her research findings into management and clinical practice across a range of care facilities nationally and internationally.

Christine has over $10M in research funding and currently holds ARC-linkage grants as a Chief Investigator. She supervises PhD, Masters and Honours students studying a range of factors related to nursing workforce and service delivery. Examples of topics include workforce flexibility in the emergency department, the impact of patient movements on nursing workload, impact of the ICU ‘hot floor’ on staff and patient outcomes, the expanded role for practice nurses, retention and the aging workforce and span of control and nursing autonomy.

Professional Associations

  • Fellow - American Academy of Nursing
  • Fellow - Australian College of Nursing
  • Fellow - Australasian College of Health Service Management (NSW)
  • Fellow - Institute of Company Directors

Research Areas and Interests

  • Nurse staffing in hospital settings
  • Nursing workforce - retention and turnover
  • Skill mix, work environment, patient outcomes
  • Developing nurse managers and workforce capacity
  • Nursing career paths


  • Doctor of Philosophy, The University of New South Wales, 1990.
  • Master of Health Planning, The University of New South Wales, 1985.


Recent Research Grants

  • Investigation of delegation practices that exist between the Registered Nurse (RN) and the Assistant in Nursing (AIN) in the acute care environment,  WA Nurses Memorial Charitable Trust,  Grant,  2018,  $5,000.
  • Core WA Data Set and Conceptual Framework,  Department of Health WA,  Grant,  2017 - 2018,  $5,000.
  • Assessing critical thinking in nurse’s development: analysis of an assessment tool,  WA Nurses Memorial Charitable Trust,  Grant,  2016 - 2017,  $10,000.

Recent Publications (within the last five years)

Journal Articles

  • Roche, M., Duffield, C., Smith, J., Kelly, D., Cook, R., Bichel-Findlay, J., Saunders, C., Carter, D., (2018), Nurse-led primary health care for homeless men: a multimethods descriptive study. International Nursing Review, in press(in press), in press, DOI: 10.1111/inr.12419.
  • Gallagher, R., Perry, L., Duffield, C., Sibbritt, D., Ying Ko, C., (2018), The health of working nurses: Hypertension prevalence, awareness, treatment and control by medication. Journal of Nursing Management, in press(in press), in press, DOI: 10.1111/jonm.12553.
  • Blay, N., Roche, M., Duffield, C., Gallagher, R., (2017), Intrahospital Transfers and the Impact on Nursing Workload. Journal of Clinical Nursing, 26(23-24), 4822-4829, DOI: 10.1111/jocn.13838.
  • Blay, N., Roche, M., Duffield, C., Xu, X., (2017), Intrahospital transfers and adverse patient outcomes: An analysis of administrative health data. Journal of Clinical Nursing, 26(23-24), 4927-4935, DOI: 10.1111/jocn.13976.
  • Perry, L., Xu, X., Duffield, C., Gallagher, R., Nicholls, R., Sibbritt, D., (2017), Health, workforce characteristics, quality of life and intention to leave: The ‘Fit for the Future’ survey of Australian nurses and midwives. Journal of Advanced Nursing, 73(11), 2745-2756, West Sussex, United Kingdom, Wiley-Blackwell Publishing Ltd., DOI: 10.1111/jan.13347.
  • Jacob, E., Duffield, C., Jacob, D., (2017), A protocol for the development of a critical thinking assessment tool for nurses using a Delphi technique. Journal of Advanced Nursing, 73(8), 1982-1988, UK, Wiley-Blackwell Publishing Ltd., DOI: 10.1111/jan.13306.
  • Abbenbroek, B., Duffield, C., Elliott, D., (2017), Intensive care unit organisation and nurse outcomes: A cross-sectional study of traditional and “hot-floor” structures. Journal of Hospital Administration, 6(3), 67-76.
  • Roche , M., Friedman, S., Duffield, C., Twigg, D., Cook, R., (2017), A comparison of nursing tasks undertaken by regulated nurses and nursing support workers: a work sampling study. Journal of Advanced Nursing, 73(6), 1421-1432, Wiley, DOI: 10.1111/jan.13224.
  • Nicholls, R., Perry, L., Duffield, C., Gallagher, R., Pierce, H., (2017), Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review. Journal of Advanced Nursing, 73(5), 1051-1065, DOI: 10.1111/jan.13185.
  • Lamont, S., Brunero, S., Perry, L., Duffield, C., Sibbritt, D., Gallagher, R., Nicholls, R., (2017), “Mental health day” sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics. Journal of Advanced Nursing, 73(5), 1172-1181, Wiley, DOI: 10.1111/jan.13212.
  • Dimitrelis, S., Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., Nicholls, R., Xu, X., (2017), Does nurses’ role, health or symptoms influence their personal use of ingestible complementary and alternative medicines?. Complementary Therapies in Medicine, 35(Dec), 39-46, DOI: 10.1016/j.ctim.2017.08.017.
  • Perry, L., Nicholls, R., Duffield, C., Gallagher, R., (2017), Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation. Journal of Advanced Nursing, 73(11), 2587-2599, West Sussex, United Kingdom, Wiley-Blackwell Publishing Ltd, DOI: 10.1111/jan.13345.
  • Duffield, C., Chapman, S., Rowbotham, S., Blay, N., (2017), Nurse-Performed Endoscopy: Implications for the Nursing Profession in Australia. Policy Politics and Nursing Practice, 18(1), 36-43, Thousand Oaks, USA, Sage Publications, Inc., DOI: 10.1177/1527154417700740.
  • Gardner , G., Duffield, C., Doubrovsky, A., Bui, U., Adams, M., (2017), The structure of nursing: a national examination of titles and practice profiles. International Nursing Review, 64(2), 233-241, West Sussex, United Kingdom, Wiley-Blackwell Publishing Ltd, DOI: 10.1111/inr.12364.
  • Elliot, D., Allen, E., McKinley, S., Perry, L., Duffield, C., Fry, M., Gallagher, R., Iedema, R., Roche, M., (2017), User compliance with documenting on a track and trigger-based observation and response chart: A two-phase multi-site audit study. Journal of Advanced Nursing, 73(12), 2892-2902, West Sussex, United Kingdom, Wiley-Blackwell Publishing Ltd., DOI: 10.1111/jan.13302.
  • Wise, S., Duffield, C., Fry, M., Roche, M., (2017), Workforce flexibility – in defence of professional healthcare work. Journal of Health, Organization and Management, 31(4), 503-516, DOI: 10.1108/JHOM-01-2017-0009.
  • Nicholls, R., Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., Xu, X., (2017), The personal cancer screening behaviours of nurses and midwives. Journal of Advanced Nursing, 73(6), 1403-1420, DOI: 10.1111/jan.13221.
  • Elliot, D., Allen, E., McKinley, S., Perry, L., Duffield, C., Fry, M., Gallagher, R., Iedema, R., Roche, M., (2016), User acceptance of observation and response charts with a track and trigger system: a multisite staff survey. Journal of Clinical Nursing, 25(15-16), 2211-2222, DOI: 10.1111/jocn.13303.
  • Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., Bichel-Findlay, J., Nicholls, R., (2016), Does nurses’ health affect their intention to remain in their current position?. Journal of Nursing Management, 24(8), 1088-1097, Wiley, DOI: 10.1111/jonm.12412.
  • Twigg, D., Myers, H., Duffield, C., Pugh, J., Gelder, L., Roche, M., (2016), The impact of adding assistants in nursing to acute care hospital ward nurse staffing on adverse patient outcomes: An analysis of administrative health data. International Journal of Nursing Studies, 63(November), 189-200, United Kingdom, Elsevier Ltd, DOI: 10.1016/j.ijnurstu.2016.09.008.
  • Duffield, C., Roche, M., Twigg, D., Williams, A., Clarke, S., (2016), A protocol to assess the impact of adding nursing support workers to ward staffing. Journal of Advanced Nursing, 72(9), 2218-2225, Blackwell Publishing Ltd, DOI: 10.1111/jan.12965.
  • Roche, M., Duffield, C., Friedman, S., Twigg, D., Dimitrelis, S., Rowbotham, S., (2016), Changes to nurses' practice environment over time. Journal of Nursing Management, 24(5), 666-675, Blackwell Publishing Ltd, DOI: 10.1111/jonm.12371.
  • Roche, M., Duffield, C., Friedman, S., Dimetrelis, S., Rowbotham, S., (2016), Regulated and unregulated nurses in the acute hospital setting: Tasks performed, delayed or not completed. Journal of Clinical Nursing, 25(1-2), 153-162, DOI: 10.1111/jocn.13118.
  • Saunders, C., Carter, D., Jordan, A., Duffield, C., Bichel-Findlay, J., (2016), Cancer patient experience measures: An evidence review. Journal of Psychosocial Oncology, 34(3), 200-222, Routledge, DOI: 10.1080/07347332.2016.1157717.
  • Gardner, G., Duffield, C., Doubrovsky, A., Adams, M., (2016), Identifying advanced practice: A national survey of a nursing workforce. International Journal of Nursing Studies, 55(2016), 60-70, United Kingdom, Elsevier Ltd, DOI: 10.1016/j.ijnurstu.2015.12.001.
  • Wise, S., Fry, M., Duffield, C., Roche, M., Buchanan, J., (2015), Ratios and nurse staffing: The vexed case of emergency departments. Australasian Emergency Nursing Journal, 18(1), 49-55, London, United Kingdom, Elsevier, DOI: 10.1016/j.aenj.2014.08.001.
  • Duffield, C., Roche, M., Dimitrelis, S., Homer, C., Buchan, J., (2015), Instability in patient and nurse characteristics, unit complexity and patient and system outcomes. Journal of Advanced Nursing, 71(6), 1288-1298, John Wiley & Sons Ltd, DOI: 10.1111/jan.12597.
  • Roche, M., Spence Laschinger, H., Duffield, C., (2015), Testing the Nursing Worklife Model in Canada and Australia: A multi-group comparison study. International Journal of Nursing Studies, 52(2), 525-534, United Kingdom, Elsevier Ltd, DOI: 10.1016/j.ijnurstu.2014.10.016.
  • Elliot, D., Allen, E., Perry, L., Fry, M., Duffield, C., Gallagher, R., Iedema, R., McKinley, S., Roche, M., (2015), Clinical user experiences of observation and response charts: focus group findings of using a new format chart incorporating a track and trigger system. BMJ Quality and Safety, 24(1), 65-75, BMJ Publishing Group, DOI: 10.1136/bmjqs-2013-002777.
  • Roche, M., Duffield, C., Dimitrelis, S., Frew , B., (2015), Leadership skills for nursing unit managers to decrease intention to leave. Nursing: Research and Reviews, 5(May), 57-64, United Kingdom, Dove Medical Press Ltd., DOI: 10.2147/NRR.S46155.
  • Twigg, D., Myers, H., Duffield, C., Giles, M., Evans, G., (2015), Is there an economic case for investing in nursing care - what does the literature tell us?. Journal of Advanced Nursing, 71(5), 975-990, Blackwell Publishing Ltd, DOI: 10.1111/jan.12577.
  • Buchan, J., Twigg, D., Dussault, G., Duffield, C., Stone, P., (2015), Policies to sustain the nursing workforce: an international perspective. International Nursing Review, 62(2), 162-170, Blackwell Publishing Ltd, DOI: 10.1111/inr.12169.
  • Scott, A., Witt, J., Duffield, C., Kalb, G., (2015), What do nurses and midwives value about their jobs? Results from a discrete choice experiment. Journal of Health Services Research and Policy, 20(1), 31-38, United Kingdom, SAGE Publications Ltd, DOI: 10.1177/1355819614554924.
  • Merrick, E., Fry, M., Duffield, C., Stasa, H., (2015), Trust and decision-making: how nurses in Australian general practice negotiate role limitations. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, 22(2), 225-232, Netherlands, Elsevier, DOI: 10.1016/j.colegn.2015.03.003.
  • Roche, MA., Duffield, C., Homer, C., Buchan, J., Dimitrelis, S., (2015), The rate and cost of nurse turnover in Australia. Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, 22(4), 353-358, Elsevier, DOI: 10.1016/j.colegn.2014.05.002.
  • Perry, L., Gallagher, R., Duffield, C., (2015), The health and health behaviours of Australian metropolitan nurses: an exploratory study. BMC Nursing, 14(1), Article number 45, London, United Kingdom, BioMed Central, DOI: 10.1186/s12912-015-0091-9.
  • Perry, L., Lamont, S., Brunero, S., Gallagher, R., Duffield, C., (2015), The mental health of nurses in acute teaching hospital settings: a cross-sectional survey. BMC Nursing, 14(1), Article no. 15, United Kingdom, BioMed Central Ltd., DOI: 10.1186/s12912-015-0068-8.
  • Duffield, C., Graham, E., Donoghue, J., Griffiths, R., Bichel-Findlay, J., Dimitrelis, S., (2015), Why older nurses leave the workforce and the implications of them staying. Journal of Clinical Nursing, 24(5-6), 824-831, Blackwell Publishing Ltd, DOI: 10.1111/jocn.12747.
  • Duffield, C., Roche, M., Homer, C., Buchan, J., Dimitrelis, S., (2014), A comparative review of nurse turnover rates and costs across countries. Journal of Advanced Nursing, 70(12), 2703-2712, West Sussex, United Kingdom, Blackwell Publishing Ltd, DOI: 10.1111/jan.12483.
  • Chenoweth, L., Merlyn, T., Jeon, Y., Tait, F., Duffield, C., (2014), Attracting and retaining qualified nurses in aged and dementia care: outcomes from an Australian study. Journal of Nursing Management, 22(2), 234-247, Online, DOI: 10.1111/jonm.12040.
  • Duffield, C., Baldwin, R., Roche, M., Wise, S., (2014), Job enrichment: creating meaningful career development opportunities for nurses. Journal of Nursing Management, 22(6), 697-706, Blackwell Publishing, DOI: 10.1111/jonm.12049.
  • Elliot, D., McKinley, S., Perry, L., Duffield, C., Iedema, R., Gallagher, R., Fry, M., Roche, M., Allen, E., (2014), Clinical Utility of an Observation and Response Chart With Human Factors Design Characteristics and a Track and Trigger System: Study Protocol for a Two-Phase Multisite Multiple-Methods Design. JMIR Research Protocols, 3(3), Article No. e40, Toronto, Canada, JMIR, DOI: 10.2196/resprot.3300.
  • Abbenbroek, B., Duffield, C., Elliot, D., (2014), Selection of an instrument to evaluate the organizational environment of nurses working in intensive care: an integrative review. Journal of Hospital Administration, 3(6), 143-162, Canada, Sciedu Press, DOI: 10.5430/jha.v3n6p143.
  • Graham, E., Donoghue, J., Duffield, C., Griffiths, R., Bichel-Findlay, J., Dimitrelis, S., (2014), Why do older RNs keep working?. Journal of Nursing Administration, 44(11), 591-597, United States, Lippincott Williams & Wilkins, DOI: 10.1097/NNA.0000000000000131.
  • Merrick, E., Fry, M., Duffield, C., (2014), Australian practice nursing: collaboration in context. Journal of Clinical Nursing, 23(2014), 3525-3532, United Kingdom, Wiley-Blackwell, DOI: 10.1111/jocn.12605.
  • Blay, N., Duffield, C., Gallagher, R., Roche, M., (2014), Methodological integrative review of the work sampling technique used in nursing workload research. Journal of Advanced Nursing, 70(11), 2434-2449, United Kingdom, John Wiley & Sons Ltd, DOI: 10.1111/jan.12466.
  • Meyer, RM., O'Briend-Pallas, L., Doran, D., Streiner, D., Ferguson-Pare, M., Duffield, C., (2014), Boundary Spanning by Nurse Managers: Effects of Managers' Characteristics and Scope of Responsibility on Teamwork. Canadian Journal of Nursing Leadership, 27(2), 42-55.
  • Blay, N., Duffield, C., Gallagher, R., Roche, M., (2014), A systematic review of time studies to assess the impact of patient transfers on nurse workload. International Journal of Nursing Practice, 20(6), 662-673, Wiley-Blackwell, DOI: 10.1111/ijn.12290.
  • Duffield, C., Twigg, D., Pugh, J., Evans, G., Dimitrelis, S., Roche, MA., (2014), The use of unregulated staff: Time for regulation?. Policy, Politics, & Nursing Practice, 15(1-2), 42-48, United States, Sage Publications Inc, DOI: 10.1177/1527154414529337.
  • Dawson, A., Buchan, J., Duffield, C., Homer, C., Wijewardena, K., (2014), Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence. Health Policy and Planning, 29(3), 396-408, DOI: 10.1093/heapol/czt026.
  • Doran, D., Duffield, C., Rizk, P., Nahm, S., Chu, CH., (2014), A descriptive study of employment patterns and work environment outcomes of specialist nurses in Canada. Clinical Nurse Specialist, 28(2), 105-114, DOI: 10.1097/NUR.0000000000000031.
  • Dawson, AJ., Stasa, H., Roche, MA., Homer, CS., Duffield, C., (2014), Nursing churn and turnover in Australian hospitals: Nurses perceptions and suggestions for supportive strategies. BMC Nursing, 13(1), article no. 11, London, United Kingdom, BioMed Central Ltd., DOI: 10.1186/1472-6955-13-11.
  • Gardner, G., Chang, A., Duffield, C., Doubrovsky, A., (2013), Delineating the practice profile of advanced practice nursing: a cross sectional survey using the modified strong model of advanced practice. Journal of Advanced Nursing, 69(9), 1931-1942, DOI: 10.1111/jan.12054.
  • Roche, M., Duffield, C., Wise, S., Baldwin, R., Fry, M., Solman, A., (2013), Domains of practice and Advanced Practice Nursing in Australia. Nursing and Health Sciences, 15(4), 497-503, DOI: 10.1111/nhs.12062.
  • Twigg, D., Duffield, C., Doleman, G., (2013), The critical role of nurses to the successful implementation of the National Safety and Quality Health Service Standards. Australian Health Review, 37(4), 541-546, DOI: 10.1071/AH12013.
  • Fry, M., Duffield, C., Baldwin, R., Roche, M., Stasa, H., Solman, A., (2013), Development of a tool to describe the role of the clinical nurse consultant in Australia. Journal of Clinical Nursing, 22(11-12), 1531-1538, DOI: 10.1111/j.1365-2702.2012.04264.x.
  • Twigg, D., Geelhoed, E., Bremner, A., Duffield, C., (2013), The economic benefits of increased levels of nursing care in the hospital setting. Journal of Advanced Nursing, 69(10), 2253-2261, DOI: 10.1111/jan.12109.
  • Baldwin, R., Duffield, C., Fry, M., Roche, M., Stasa, H., Solman, A., (2013), The role and functions of Clinical Nurse Consultants, an Australian advanced practice role: a descriptive exploratory cohort study. International Journal of Nursing Studies, 50(3), 326-334, United Kingdom, Pergamon, DOI: 10.1016/j.ijnurstu.2012.09.013.
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