Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures

Abstract

BackgroundTwenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone.MethodsData were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures.ResultsSeventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18–2.28, p = 0.003).Mean ‘care left undone’ scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01–10.00 h), 3.80 (10.01–11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06–1.20, p < 0.001).Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17–1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01–10.00 h), 39.5% (10.01–11.99 h).ConclusionsOur findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.

Job satisfaction and associated factors among psychiatric nurses in tertiary psychiatric hospitals: Results from a nationwide cross‐sectional study

“…Working more than 40 hr per week was negatively associated with job satisfaction, similar to previous research (Ball et al, ; Baum & Kagan, ; Li & Lambert, ; Van, Clarke, Willems, et al, ), while monthly income level was positively associated with job satisfaction, echoing the results of previous research (Holmberg et al, ; Tarcan et al, ). Reducing required work hours and ensuring fair compensation may help in enhancing job satisfaction among Chinese psychiatric nurses.…”

“…Some factors related to stressors have also been associated with nurses’ job satisfaction. Specifically, low income (Holmberg, Sobis, & Carlström, ; Tarcan et al, ), heavy workload (Ball et al, ; Baum & Kagan, ; Li & Lambert, ; Van, Clarke, Willems, & Mondelaers, ), and poor collaboration with physicians were all associated with lower nurse job satisfaction (Van, Clarke, Willems, et al, ; Van, Clarke, Wouters, et al, ; Zhang, Huang, Liu, Yan, & Li, ). Perceptions of respect from patients and social recognition of the specialty were positively associated with job satisfaction (Lu et al, ; Zhou et al, ), while patient‐initiated violence was negatively associated with nurse’ job satisfaction (Chang & Cho, ; Cheung et al, ; Cheung & Yip, ; Purpora & Blegen, ).…”

Association between sleep quality and nurse productivity among Korean clinical nurses

“…The nurse staffing level is especially poor in medium‐ and small‐sized hospitals in Korea (Cho et al., ). The evidence that long shift length is no longer a statistically significant predictor of patient safety considering nurse staffing levels (Ball et al., ) strongly suggests that a viable solution to alleviate clinical nurses’ sleep problems resides in providing an adequate nursing workforce.…”

12‐hr shifts in nursing: Do they remove unproductive time and information loss or do they reduce education and discussion opportunities for nurses? A cross‐sectional study in 12 European countries

“…Furthermore, there is a growing number of studies suggesting that shifts of 12 hr or more are associated with adverse outcomes for both patients and nurses, with nurses reporting both lower quality of care and increased omissions in necessary care to be associated with working long shifts (Ball et al, ; Dall’Ora, Griffiths, et al, ; Dall'Ora, Ball, Recio‐Saucedo, & Griffiths, ; Griffiths et al, ; Stimpfel & Aiken, ). These findings raise the possibility that far from reducing unproductive time, which adds little value to nursing care, the move to shifts of 12 hr or more may negatively impact nurses' ability to deliver safe and effective care.…”