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Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures

Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures
Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures
Background

Twenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone.

Methods

Data were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures.

Results

Seventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18–2.28, p = 0.003).

Mean ‘care left undone’ scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01–10.00 h), 3.80 (10.01–11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06–1.20, p < 0.001).

Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17–1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01–10.00 h), 39.5% (10.01–11.99 h).

Conclusions

Our findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.

1472-6955
1-7
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Day, Tina
e2c49070-9670-44d0-bfe0-bffb4999ca70
Murrells, Trevor
9a57589a-d893-415c-8c3d-8b25d052f42c
Dall'ora, Chiara
4501b172-005c-4fad-86da-2d63978ffdfd
Rafferty, Anne Marie
f8585833-856a-4b45-9da2-16103331152e
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Maben, Jill
3240b527-420c-498e-9f66-557b96561f40
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Day, Tina
e2c49070-9670-44d0-bfe0-bffb4999ca70
Murrells, Trevor
9a57589a-d893-415c-8c3d-8b25d052f42c
Dall'ora, Chiara
4501b172-005c-4fad-86da-2d63978ffdfd
Rafferty, Anne Marie
f8585833-856a-4b45-9da2-16103331152e
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Maben, Jill
3240b527-420c-498e-9f66-557b96561f40

Ball, Jane, Day, Tina, Murrells, Trevor, Dall'ora, Chiara, Rafferty, Anne Marie, Griffiths, Peter and Maben, Jill (2017) Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC Nursing, 16 (26), 1-7. (doi:10.1186/s12912-017-0221-7).

Record type: Article

Abstract

Background

Twenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone.

Methods

Data were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures.

Results

Seventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18–2.28, p = 0.003).

Mean ‘care left undone’ scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01–10.00 h), 3.80 (10.01–11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06–1.20, p < 0.001).

Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17–1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01–10.00 h), 39.5% (10.01–11.99 h).

Conclusions

Our findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.

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More information

Accepted/In Press date: 16 May 2017
e-pub ahead of print date: 25 May 2017
Published date: 2017

Identifiers

Local EPrints ID: 412890
URI: http://eprints.soton.ac.uk/id/eprint/412890
ISSN: 1472-6955
PURE UUID: f0db6c9a-7353-4347-8155-7ca2a99616e6
ORCID for Jane Ball: ORCID iD orcid.org/0000-0002-8655-2994
ORCID for Chiara Dall'ora: ORCID iD orcid.org/0000-0002-6858-3535
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

Catalogue record

Date deposited: 07 Aug 2017 13:43
Last modified: 17 Dec 2019 01:40

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