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Nurse Schedules Can Affect Quality
of Care

 A new study has found that patient deaths were significantly more likely in hospitals where nurses reported working long hours. “Alertness and vigilance required for providing good nursing care depend upon having an adequate duration of quality sleep and rest,” says the study’s author Alison Trinkoff, “and long work hours can impact the quality of nursing care and can increase the potential for error.”

The finding was just one of several from a study of nurses' work schedules, patient outcomes and staffing conducted by University of Maryland School of Nursing researchers in collaboration with researchers at the Johns Hopkins University School of Medicine.

Trinkoff, a professor of nursing at the University of Maryland, and her co-authors linked patient outcome and staffing information from 71 acute care hospitals in two representative states (Illinois and North Carolina) with the survey responses of 633 randomly selected nurses who worked in these hospitals. The findings are published in the January/February 2011 issue of the journal Nursing Research.

Further study needed

Most U.S. hospitals use 12-hour nursing shifts exclusively (as opposed to eight-hour shifts), a trend that began in the 1980s during nursing shortages nationwide, the study notes.

“Although many nurses like these schedules because of the compressed nature of the workweek, the long schedule as well as shift work in general lead to sleep deprivation,” says Trinkoff.

“Lack of time off” was the work schedule component that was most frequently related to mortality in this study, along with long work hours. In a previous study, Trinkoff and her colleagues found that lack of time off was also an important factor contributing to nurse injury and fatigue. Nurses need time off to rest and recuperate to protect their health and, similarly, the lack of recovery time may affect performance, she says.

“The finding that work schedule can impact patient outcomes is important, and should lead to further study and examination of nursing work schedules,” says Trinkoff. “Now that we have data that these conditions affect the public adversely, there is even more reason for providers in each hospital and clinic to look at the situation and find solutions.” [Adrienne Coles/University of Maryland press release]

February 15, 2011