Is It Time to Pull the Plug on 12-Hour Shifts?

ArticleinThe Journal of nursing administration 40(3):100-2 · March 2010with218 Reads
DOI: 10.1097/NNA.0b013e3181d0414e · Source: PubMed
Abstract
Shift durations of 12 hours or more are now ubiquitous in hospitals, with currently working staff nurses reporting satisfaction with this shift length, although others who prefer shorter work hours have generally left hospital nursing. Nurse administrators are beginning to question the wisdom of having nurses work extended hours. In part 1 of this 2-part series, the authors provide an update on recent findings that challenge the current scheduling paradigm that supports unsafe long work hours. Part 2 discusses obstacles that nurse administrators face when they "buck the 12-hour trend" and offers guidance for introducing work schedule changes.
    • "Taken together, the study provides evidence that workfamily support may be an important predictor influencing workers' performance in care quality. Interpretation of these results does not completely apply to ongoing debates about physicians' and nurses' hours and performance on care quality (Brown and Trinkoff, 2010 ). Additional job connotes extra hours, especially in our sample where 81% of those with additional hours were already full-time employees. "
    [Show abstract] [Hide abstract] ABSTRACT: We analyzed qualitative and quantitative data from U.S.-based employees in 30 long-term care facilities. Analysis of semi-structured interviews from 154 managers informed qualitative analyses. Quantitative data include 1,214 employees’ scoring of their supervisors and their organizations on family supportiveness (individual scores and aggregated to facility level), and three outcomes: (1), care quality indicators assessed at facility level (n=30) and collected monthly for six months after employees’ data collection; (2), employees’ dichotomous survey response on having additional off-site jobs; and (3), proportion of employees with additional jobs at each facility. Thematic analyses revealed that managers operate within the constraints of an industry that simultaneously: (a) employs low-wage employees with multiple work-family challenges, and (b) has firmly institutionalized goals of prioritizing quality of care and minimizing labor costs. Managers universally described providing work-family support and prioritizing care quality as antithetical to each other. Concerns surfaced that family-supportiveness encouraged employees to work additional jobs off-site, compromising care quality. Multivariable linear regression analysis of facility-level data revealed that higher family-supportive supervision was associated with significant decreases in residents’ incidence of all pressure ulcers (-2.62%) and other injuries (-9.79%). Higher family-supportive organizational climate was associated with significant decreases in all falls (-17.94%) and falls with injuries (-7.57%). Managers’ concerns about additional jobs were not entirely unwarranted: multivariable logistic regression of employee-level data revealed that among employees with children, having family-supportive supervision was associated with significantly higher likelihood of additional off-site jobs (RR 1.46, 95%CI 1.08-1.99), but family-supportive organizational climate was associated with lower likelihood (RR 0.76, 95%CI 0.59-0.99). However, proportion of workers with additional off-site jobs did not significantly predict care quality at facility levels. Although managers perceived providing work-family support and ensuring high care quality as conflicting goals, results suggest that family-supportiveness is associated with better care quality.
    Full-text · Article · Mar 2016
    • "Nurses work 12-hour shits to provide continuous 24-hour inpatient care creating sleep deprivation and higher stress demands. Consequently, risks for chronic illnesses such as obesity, hypertension, diabetes, and other mental or physical ailments increase [12]. he American Nurses Association (ANA) Health System Reform Agenda highlighted support for quality health care policies to be based on outcomes relecting the Six Quality of Aims guidelines of the IOM report. "
    Article · Nov 2015 · Journal of the American Psychiatric Nurses Association
    • "However, despite a growing body of research evidence linking occupational fatigue to long work hours, the tradition of extended shift work and 12-hour shifts among hospital nurses continues. The mainstreaming of 12-hour shifts among hospital nurses in the United States is one of the greatest barriers to moving away from the practice (Rogers, Weing-Ting, Scott, Aiken, & Dinges, 2004; Geiger-Brown & Trinkoff, 2010a; Lothschuetz-Montgomery & Geiger-Brown, 2010). The Institute of Medicine (2004) published a landmark report calling for the transformation of the hospital work environments across the United States, solidifying the role of the frontline nurse at the center of patient safety. "
    Full-text · Article · Feb 2015
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