Other Titles
Global Issues Within the Nursing Workforce
Abstract
Session presented on Saturday, July 26, 2014:
Purpose: In some countries, there is a move toward nurses working shifts of longer duration to reduce time and cost of shift handovers and staff overlap, and to potentially improve work life balance; 12 hour shifts have become the norm in some countries and hospitals. However, concerns have been raised as to whether nurses can perform reliably and effectively when working longer shifts. This presentation gives the results of a study that aims to describe shift patterns of European nurses and to investigate whether shift length is associated with nurse-reported quality and safety of care and with aspects of needed nursing care left undone.
Methods: Cross-sectional survey of 31,627 registered nurses (RN) in 2170 general medical/surgical units within 487 acute general hospitals across 12 European countries. Multi-level regression modelling to explore associations between shift work and nurse reported measures of quality and safety of care.
Results: Most nurses (50.5%) reported working shifts <8 hours, whilst 15% of nurses worked shifts >12. There was considerable variation in typical shift length between countries and within some countries. For example in Spain 90% of day shifts were ?8 hours compared to 45% in Englandand 9% in Ireland with 73% of nurses working 12 hour day shifts. Working a shift of >12 hours was associated with nurses being more likely to report poor or failing patient safety (OR 1.46 95% CI 1.16 - 1.83), and poor or fair quality of care (OR 1.39, 95% CI 1.00-1.85). Nurses reported a significantly increased number of care activities needed, but left undone on their last shift when working any shift >8 hours (OR 1.04 to1.13). Working beyond contracted hours was also associated with reports of poor or fair quality of care (OR = 1.35), poor or failing patient safety (OR = 1.67) and missed care (OR = 1.29).
Conclusion: European nurses working 12 hours or longer and those working overtime were more likely to report low quality and safety ratings. Policies to adopt a 12 hour nursing shift length should proceed with caution. Use of overtime (i.e. working a longer shift than contracted) to mitigate staffing shortages or increase flexibility may also incur additional risk to quality. Further research is required using objective measures of quality and safety and patient experience.
Sigma Membership
Unknown
Type
Presentation
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
Workforce, Quality of Care, Shift Work
Recommended Citation
Griffiths, Peter, "Registered nurses extended work shifts and the association with quality of nursing care and patient safety: A cross sectional survey in twelve European countries" (2014). INRC (Congress). 332.
https://www.sigmarepository.org/inrc/2014/presentations_2014/332
Conference Name
25th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Hong Kong
Conference Year
2014
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Acquisition
Proxy-submission
Registered nurses extended work shifts and the association with quality of nursing care and patient safety: A cross sectional survey in twelve European countries
Hong Kong
Session presented on Saturday, July 26, 2014:
Purpose: In some countries, there is a move toward nurses working shifts of longer duration to reduce time and cost of shift handovers and staff overlap, and to potentially improve work life balance; 12 hour shifts have become the norm in some countries and hospitals. However, concerns have been raised as to whether nurses can perform reliably and effectively when working longer shifts. This presentation gives the results of a study that aims to describe shift patterns of European nurses and to investigate whether shift length is associated with nurse-reported quality and safety of care and with aspects of needed nursing care left undone.
Methods: Cross-sectional survey of 31,627 registered nurses (RN) in 2170 general medical/surgical units within 487 acute general hospitals across 12 European countries. Multi-level regression modelling to explore associations between shift work and nurse reported measures of quality and safety of care.
Results: Most nurses (50.5%) reported working shifts <8 >hours, whilst 15% of nurses worked shifts >12. There was considerable variation in typical shift length between countries and within some countries. For example in Spain 90% of day shifts were ?8 hours compared to 45% in Englandand 9% in Ireland with 73% of nurses working 12 hour day shifts. Working a shift of >12 hours was associated with nurses being more likely to report poor or failing patient safety (OR 1.46 95% CI 1.16 - 1.83), and poor or fair quality of care (OR 1.39, 95% CI 1.00-1.85). Nurses reported a significantly increased number of care activities needed, but left undone on their last shift when working any shift >8 hours (OR 1.04 to1.13). Working beyond contracted hours was also associated with reports of poor or fair quality of care (OR = 1.35), poor or failing patient safety (OR = 1.67) and missed care (OR = 1.29).
Conclusion: European nurses working 12 hours or longer and those working overtime were more likely to report low quality and safety ratings. Policies to adopt a 12 hour nursing shift length should proceed with caution. Use of overtime (i.e. working a longer shift than contracted) to mitigate staffing shortages or increase flexibility may also incur additional risk to quality. Further research is required using objective measures of quality and safety and patient experience.