Nurses' perceptions of shift length

Haller, Teresa; Quatrara, Beth; Letzkus, Lisa; Keim‐Malpass, Jessica

doi:10.1097/01.numa.0000546202.40080.c1

Cited by 11 publications

(24 citation statements)

References 14 publications

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“…Our findings confirmed those of small scale qualitative studies, highlighting that working on long shift patterns and, therefore, losing the long overlap between shifts, leads to fewer opportunities to engage in educational activities and in discussions around patient care (McGettrick & O'Neill, ). Contrary to reports that long shifts foster continuity of care and reduce information loss (Haller et al, ; NHS Evidence, ; Wootten, ), our study found no significant associations between working shifts of 12 hr or more and continuity of care and information loss.…”

Section: Discussioncontrasting

confidence: 99%

“…Since incidents often occur when responsibility is transferred from one person to another, reducing the number of transfers in a 24‐hr period decreases the opportunity for information to be lost or miscommunicated (Baillie & Thomas, ). An additional claimed benefit of long shifts and the associated reduction in handovers is that patients interact with the same nurse all day; there are reports that patients become confused when their carer changes during the day, hence the claim that shifts of 12 hr or more can improve continuity of care (Haller, Quatrara, Letzkus, & Keim‐Malpass, ; NHS Evidence, ; Thomson, Schneider, & Hare Duke, ; Wootten, ).…”

Section: Introductionmentioning

confidence: 99%

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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

Dall’Ora

Griffiths

Emmanuel

et al. 2019

Journal of Clinical Nursing

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Aims and objectivesTo examine the association between registered nurses' (referred to as “nurses” for brevity) shifts of 12 hr or more and presence of continuing educational programmes; ability to discuss patient care with other nurses; assignments that foster continuity of care; and patient care information being lost during handovers.BackgroundThe introduction of long shifts (i.e., shifts of 12 hr or more) remains controversial. While there are claims of efficiency, studies have shown long shifts to be associated with adverse effects on quality of care. Efficiency claims are predicated on the assumption that long shifts reduce overlaps between shifts; these overlaps are believed to be unproductive and dangerous. However, there are potentially valuable educational and communication activities that occur during these overlaps.DesignCross‐sectional survey of 31,627 nurses within 487 hospitals in 12 European countries.MethodsThe associations were measured through generalised linear mixed models. The study methods were compliant with the STROBE checklist.ResultsWhen nurses worked shifts of 12 hr or more, they were less likely to report having continuing educational programmes; and time to discuss patient care with other nurses, compared to nurses working 8 hr or less. Nurses working shifts of 12 hr or more were less likely to report assignments that foster continuity of care, albeit the association was not significant. Similarly, working long shifts was associated with reports of patient care information being lost during handovers, although association was not significant.ConclusionWorking shifts of 12 hr or more is associated with reduced educational activities and fewer opportunities to discuss patient care, with potential negative consequences for safe and effective care.Relevance to clinical practiceImplementation of long shifts should be questioned, as reduced opportunity to discuss care or participate in educational activities may jeopardise the quality and safety of care for patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Dall’Ora

Griffiths

Emmanuel

et al. 2019

Journal of Clinical Nursing

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show abstract

“…Noticeably, nurses observed that the reduction in consecutive shifts decreased work absence [ 38 ]. Fatigue could be manifested by physical pain [ 41 ], difficulty to transition from day to night-time (and vice-versa) [ 42 ], reduced concentration [ 27 , 37 ], difficulty in taking decisions or emotional manifestation, such as being easily annoyed or unengaged during shift [ 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…Across different studies there were contrasting results for nurses’ views about the impact of long shifts on the quality and continuity of care after 12 hour shifts were implemented. Long shifts were perceived by unregistered healthcare staff [ 37 ] and nurses to improve patient and continuity of care [ 38 , 41 , 42 , 45 , 46 , 48 , 49 ]. The implementation of long shifts rendered possible the full completion of their nursing tasks, as evidenced by fewer interruptions of work tasks and the possibility to focus on their tasks for longer [ 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Long shifts were perceived by unregistered healthcare staff [ 37 ] and nurses to improve patient and continuity of care [ 38 , 41 , 42 , 45 , 46 , 48 , 49 ]. The implementation of long shifts rendered possible the full completion of their nursing tasks, as evidenced by fewer interruptions of work tasks and the possibility to focus on their tasks for longer [ 41 , 42 ]. Nurses perceived improved communication with patients [ 42 ], as they were able to care for the same patients throughout their shifts [ 48 ].…”

Section: Resultsmentioning

confidence: 99%

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Nurses’ experiences and preferences around shift patterns: A scoping review

2021

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Objective To explore the evidence on nurses’ experiences and preferences around shift patterns in the international literature. Data sources Electronic databases (CINHAL, MEDLINE and Scopus) were searched to identify primary studies up to April 2021. Methods Papers reporting qualitative or quantitative studies exploring the subjective experience and/or preferences of nurses around shift patterns were considered, with no restrictions on methods, date or setting. Key study features were extracted including setting, design and results. Findings were organised thematically by key features of shift work. Results 30 relevant papers were published between 1993 and 2021. They contained mostly qualitative studies where nurses reflected on their experience and preferences around shift patterns. The studies reported on three major aspects of shift work: shift work per se (i.e. the mere fact of working shift), shift length, and time of shift. Across all three aspects of shift work, nurses strive to deliver high quality of care despite facing intense working conditions, experiencing physical and mental fatigue or exhaustion. Preference for or adaptation to a specific shift pattern is facilitated when nurses are consulted before its implementation or have a certain autonomy to self-roster. Days off work tend to mitigate the adverse effects of working (short, long, early or night) shifts. How shift work and patterns impact on experiences and preferences seems to also vary according to nurses’ personal characteristics and circumstances (e.g. age, caring responsibilities, years of experience). Conclusions Shift patterns are often organised in ways that are detrimental to nurses’ health and wellbeing, their job performance, and the patient care they provide. Further research should explore the extent to which nurses’ preferences are considered when choosing or being imposed shift work patterns. Research should also strive to better describe and address the constraints nurses face when it comes to choice around shift patterns.

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Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector

Caruso

Arbour

Berger

et al. 2022

American J Industrial Med

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Background The services of Healthcare and Social Assistance (HCSA) workers are needed by society around the clock. As a result, these workers are exposed to shift work and long work hours. The combination of demanding work schedules and other hazards in the HCSA work environment increases the health and safety risks to these workers, as well as to their patients/clients and the public. Methods This paper has three aims: (1) provide an overview of the burden of shift work, long hours, and related sleep and fatigue problems in this sector; (2) suggest research priorities that would improve these; and (3) discuss potential positive impacts of addressing these research priorities for the health and safety of workers and the public. The authors used a modified Delphi approach to anonymously rank‐order priorities for improving HCSA worker health and safety and public safety. Input was also obtained from attendees at the 2019 National Institute for Occupational Safety and Health (NIOSH) Work Hours, Sleep, and Fatigue Forum. Results The highest rated research priorities were developing better designs for work schedules, and improving the HCSA culture and leadership approaches to shift work and long work hours. Additional priorities are identified. Conclusion Research in these priority areas has the potential to benefit HCSA workers as well as their patients/clients, employers, and society.

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Nurses' perceptions of shift length

Cited by 11 publications

References 14 publications

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

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

Nurses’ experiences and preferences around shift patterns: A scoping review

Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector

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