Περίληψη:
Background: Despite concerns as to whether nurses can perform reliably and effectively when working longer shifts, a pattern of two 12-to 13-hour shifts per day is becoming common in many hospitals to reduce shift to shift handovers, staffing overlap, and hence costs.
Objectives: To describe shift patterns of European nurses and investigate whether shift length and working beyond contracted hours (overtime) is associated with nurse-reported care quality, safety, and care left undone.
Methods: Cross-sectional survey of 31,627 registered nurses in general medical/surgical units within 488 hospitals across 12 European countries.
Results: A total of 50% of nurses worked shifts of r8 hours, but 15% worked Z12 hours. Typical shift length varied between countries and within some countries. Nurses working for Z12 hours were more likely to report poor or failing patient safety [odds ratio (OR) = 1.41; 95% confidence interval (CI), 1.13-1.76], poor/fair quality of care (OR=1.30; 95% CI, 1.10-1.53), and more care activities left undone (RR = 1.13; 95% CI, 1.09-1.16). Working overtime was also associated with reports of poor or failing patient safety (OR = 1.67; 95% CI, 1.51-1.86), poor/fair quality of care (OR=1.32; 95% CI, 1.23-1.42), and more care left undone (RR=1.29; 95% CI, 1.27-1.31).
Conclusions: European registered nurses working shifts of Z12 hours and those working overtime report lower quality and safety and more care left undone. Policies to adopt a 12-hour nursing shift pattern should proceed with caution. Use of overtime working to mitigate staffing shortages or increase flexibility may also incur additional risk to quality. Copyright © 2014 by Lippincott Williams & Wilkins.
Συγγραφείς:
Griffiths, P.
Dall'Ora, C.
Simon, M.
Ball, J.
Lindqvist, R.
Rafferty, A.-M.
Schoonhoven, L.
Tishelman, C.
Aiken, L.H.
Sermeus, W.
Van Den Heede, K.
Bruyneel, L.
Lesaffre, E.
Diya, L.
Smith, H.
Sloane, D.
Jones, S.
Kinnunen, J.
Ensio, A.
Jylhä, V.
Busse, R.
Zander, B.
Blümel, M.
Mantas, J.
Zikos, D.
Diomidous, M.
Scott, A.
Matthews, A.
Staines, A.
Holter, I.M.
Sjetne, I.S.
Brzostek, T.
Kózka, M.
Brzyski, P.
Moreno-Casbas, T.
Fuentelsaz-Gallego, C.
Gonzalez-María, E.
Gomez-Garcia, T.
Alenius, L.S.
De Geest, S.
Schubert, M.
Schwendimann, R.
Heinen, M.
Van Achterberg, T.
Λέξεις-κλειδιά:
adult; Article; clinical handover; cross-sectional study; Europe; female; health care quality; health care survey; human; major clinical study; male; middle aged; night work; nursing shortage; nursing staff; patient care; patient safety; registered nurse; shift worker; surgical ward; ward; working time; epidemiology; organization and management; personnel management; standards; statistics and numerical data; work schedule, Cross-Sectional Studies; Europe; Humans; Nursing Staff, Hospital; Patient Safety; Personnel Staffing and Scheduling; Quality of Health Care; Work Schedule Tolerance
