L’uso dei turni di 12 ore sugli esiti degli infermieri, dei pazienti e dell’organizzazione. Una revisione critica della letteratura

Abstract

Introduction: the use of 12-hour shifts has been considered beneficial in reducing staffing costs, attracting more nurses, improving work-life balance, and organizing care more efficiently. 

Objective: the aim of this review is to critically examine the available evidence on the impact of 12-hour shifts on nurse, patient, and organizational outcomes. 

Methods: a critical review of the literature was undertaken. Quantitative, qualitative and mixed methods studies analyzing the effect of long shifts (>12 working hours) were included. The search was performed on MEDLINE through PubMed and Cinhal. 

Results: fifty-four articles were included, covering publications from 1976 to 2024. Evidence suggests that nursing care and patient safety may deteriorate with 12-hour shifts, with mixed findings on continuity of care. 12-hour shifts can lead to increased nurses' fatigue, without a decrease in job performance, and can have negative impacts on physical health, continuing education, burnout, and job satisfaction. While qualitative studies indicate improved work-life balance, this is not supported by empirical evidence. One study suggests a decrease in costs, but the effects on sick leave are inconclusive. Additionally, intention-to-leave among nurses appears to increase.

Conclusions: the evidence generally does not support the use of 12-hour shifts. However, due to methodological limitations in the included studies, firm conclusions cannot be drawn. Organizations and nurses should carefully consider the introduction of 12-hour shifts, evaluating nurses' needs and implementing patient-centered care models that support nursing professionalism, along with a continuous monitoring of patient, nurse, and organizational outcomes.

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