Comparison of Nurse, System and Quality Patient Care Outcomes in 8-Hour and 12-Hour Shifts

Du, Yunling; Cowell, Rhabia; Amsterdam, Norma; Helfrich, Thomas A; Linn, Robert W; Gladstein, Amy; Walsh, Mary B.; Mojica, Lorraine A

doi:10.1097/01.mlr.0000237180.72275.82

Cited by 81 publications

(80 citation statements)

References 34 publications

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“…This is consistent with an earlier study in which statistically significant alterations in error rate were not seen until shifts reached 12.5 hours or longer. 7 This possibility is supported by several other studies [21][22][23] indicating neutral or positive relationships between shift length and performance for shifts of 8 and 12 hours in duration. As both rote and cognitively intense tasks are important in the PICU environment, the relationships between work hours and both task types need to be clarified further.…”

Section: Effect Of Work Hours On Task Completion Rate and Accuracysupporting

confidence: 79%

Using Simulation to Investigate the Impact of Hours Worked on Task Performance in an Intensive Care Unit

Calhoun¹,

Boone²,

Dauer³

et al. 2014

American Journal of Critical Care

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Background Past studies have indicated a positive correlation between shift length and the rate of medical errors. In situ simulation is an innovative way to study issues in quality of care. Objectives To explore the use of in situ simulation as an investigative method by using it to examine the effects of work length on completion rate of and accuracy at critical care nursing tasks. Methods Participants were drawn from the nursing staff in the pediatric intensive care unit and were assessed by using a high-fidelity pediatric simulator 3 times during a 12-hour shift. Data recorded included demographic information, time to task completion, and number of steps correctly performed per task. Results Twenty-eight nurses with a mean of 5.5 years of experience participated. Each nurse cared for a mean of 1.4 patients per shift. A significant decrease (P < .001) of 5.5 minutes was noted in mean completion time across assessment intervals (from 17.9 to 13.3, to 12.4 min). No significant changes in accuracy were noted. Some accuracy issues seemed attributable to simulation artifact, whereas the use of simulation enabled greater standardization in other aspects of the study. Conclusion Critical care nurses take significantly less time to complete tasks at the end of their shift than at the beginning. This, coupled with a lack of change in accuracy of task completion over time, suggests that nursing performance of simple tasks may improve over the course of a 12-hour shift. Simulation can be an effective means to address some quality improvement issues.

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Section: Effect Of Work Hours On Task Completion Rate and Accuracysupporting

confidence: 79%

Using Simulation to Investigate the Impact of Hours Worked on Task Performance in an Intensive Care Unit

Calhoun¹,

Boone²,

Dauer³

et al. 2014

American Journal of Critical Care

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“…[48] This design was developed and the data collected by survey from adult general inpatient units. The authors identified study variables which were nursing outcomes, while the independent variable was identified based on the type of shift length (12 or 8-hour shifts).…”

Section: The Impact Of the 12-hour Shift On Fatiguementioning

confidence: 99%

The impact of 12-hour shifts on nurses’ health, wellbeing, and job satisfaction: A systematic review

Banakhar

2017

JNEP

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Objective: This review was conducted to investigate the impact of applying 12-hour shifts in comparison to 8-hour shifts on nurses' health wellbeing and job satisfaction. Methods: MEDLINE, CINHALE, PsycINFO, EMBASE, Web of Science, and SCOPUS databases were searched, covering the period between 1980 to 2017. Studies were included if they concerned nurses working for 12-hour shifts in comparison to 8-hour shifts in hospital settings, based on observational/surveys studies. Results: In the yielded 12 studies, 3 studies reported that 12-hour shifts had an impact on nurses' health and wellbeing, such as cognitive anxiety, musculo-skeletal disorders, sleep disturbance, and role stress; however, there was no significant difference between 12-and 8-hour shifts with digestive and cardiovascular disorders, psychological ill health, and somatic anxiety. Of the 4 studies measuring the impact of 12-hour shifts on fatigue, three studies showed that the nurses experienced more fatigue in the 12-hour shifts in comparison to 8-hour shifts; nevertheless, one study did not find a significant difference in fatigue and critical thinking performances between 12-and 8-hour shifts. Nine of the 12 studies measured job satisfaction in 12-and 8-hour shifts, 5 studies showed a greater dissatisfaction regarding 12-hour shifts, while 3 studies found that the nurses were more satisfied with 12-hour shifts than with 8-hour shifts; but one study pointed out that there was a difference between the two shifts considering pay and professional status. Conclusions: The findings of the review suggest that 12-hour shifts resulted in negative health concerns and job dissatisfaction; however, there is a need for more empirical evidence to support this.

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“…There is a lack of guide that can provide policy-makers the optimal duty length (Stone et al, 2006). Many studies have illustrated that nurse duty hours' length has a mixed effect on patient safety and quality outcomes (Estabrooks et al, 2009;Philibert, Nasca, Brigham, & Shapiro, 2013;Stone et al, 2006). For instance, some studies have found that limiting duty hours leads to decreased continuity of care and increased workload, which in turn negatively affect patient safety and staff performance (Philibert et al, 2013).…”

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Nursing Duty Hours’ Length and the Perceived Outcomes of Care

Jarrar¹,

Rahman²,

Sebiany³

et al. 2018

GJHS

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Background and objective: Working long shifts are associated with fatigue, medical errors and poor outcomes of care. However, there is a lack of guide that can provide policy-makers the optimal duty length in the Malaysian hospitals. The study aims to investigate the impact of nursing duty hours' length on the quality and safety of care delivered in the "Medical-Surgical Wards" in Malaysia.Method: Cross-sectional study was carried out on 12 private hospitals. Data was collected, through questionnaires, from 652 nurses (61.8 % response rate). Stratified random sampling was used in the study. Regression analyses were conducted to explore the impact of the nursing duty hours' length on the care quality and safety. Findings:The length of nurses' duty hours is not significantly affecting care quality (F = 1.27 and P value = 0.28) and patient safety (F = 1.81 and P value = 0.13), at p<0.05 significance level. Conclusion:Nurse working in hospitals with 10-hours night shift had perceived poor quality (B=-0.11, t=-1.64, p=0.10); and unsafe care (B=-0.17, t=-2.40, p=0.02). Policy makers in Malaysian hospitals can benefit from the study by restructuring duty hours' length in their hospital.

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Comparison of Nurse, System and Quality Patient Care Outcomes in 8-Hour and 12-Hour Shifts

Cited by 81 publications

References 34 publications

Using Simulation to Investigate the Impact of Hours Worked on Task Performance in an Intensive Care Unit

Using Simulation to Investigate the Impact of Hours Worked on Task Performance in an Intensive Care Unit

The impact of 12-hour shifts on nurses’ health, wellbeing, and job satisfaction: A systematic review

Nursing Duty Hours’ Length and the Perceived Outcomes of Care

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