Nurses’ shift length and overtime working in 12 European countries

Peter Griffiths, Chiara Dall'ora, Michael Simon, Jane Ball, Rikard Lindqvist, Anne-Marie Rafferty, Lisette Schoonhoven, Carol Tishelman, Linda H. Aiken

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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 =12 hours. Typical shift length varied between countries and within some countries. Nurses working for >=12 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 >=12 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.
Original languageEnglish
Pages (from-to)975-981
Number of pages7
JournalMedical Care
Volume52
Issue number11
DOIs
Publication statusPublished - Nov 2014
Externally publishedYes

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