12 Hour Shifts: Literature Reviewed, Wise Use Challenged

The effect of full-time culture on quality and safety of care – a literature review

Purpose

The purpose of this study is to increase knowledge and understanding of the relationship between full-time-culture and the outcome for quality and safety of care.

Design/methodology/approach

The paper is a literature review with a qualitatively oriented thematic analysis concerning quality or safety outcomes for patients, or patients and staff when introducing a full-time culture.

Findings

Identified factors that could have a positive or negative impact on quality and patient safety when introducing full-time culture were length of shift, fatigue/burnout, autonomy/empowerment and system/structure. Working shifts over 12 h or more than 40 h a week is associated with increased adverse events and errors, lower quality patient care, less attention to safety concerns and more care left undone. Long shifts give healthcare personnel more flexibility and better quality-time off, but there is also an association between long shifts and fatigue or burnout. Having a choice and flexibility around shift patterns is a predictor of increased wellbeing and health.

Originality/value

A major challenge across healthcare services is having enough qualified personnel to handle the increasing number of patients. One of the measures to get enough qualified personnel for the expected tasks is to increase the number of full-time employees and move towards a full-time culture. It is argued that full-time culture will have a positive effect on work environment, efficiency and quality due to a better allocation of work tasks, predictable work schedule, reduced sick leave, and continuity in treatment and care. There is limited research on how the introduction of full-time culture will affect the quality and safety for patients and staff, and few studies have been focusing on the relationship between longer shift, work schedule, and quality and safety of care.

The Postpandemic Nursing Workforce: Increasing Fill Rates and Reducing Workload Through a Generational Design of Workforce Layers

Inequities between nursing workforce supply and demand continue to challenge nurse executives in creating the vision for a postpandemic nursing workforce. Health system's workforce redesign strategies must prioritize the changing needs of the multigenerational workforce to maximize the available supply of nurses willing to remain in the workforce. A test of a newly designed flexible workforce framework, aimed to meet the needs of the multigenerational workforce, resulted in increased fill rates and decreased costs of labor.

Chronic and acute fatigue and intershift recovery in undergraduate nursing students working 12 or 6-hour faculty-supervised clinical shifts

BACKGROUND

Nursing student fatigue and recovery time are important considerations.

PURPOSE

This descriptive research compared chronic/acute fatigue and recovery time between one 12-hour shift or two 6-hour faculty-supervised clinical shifts per week.

METHODS

The Occupational Fatigue and Exhaustion Recovery (OFER) scale was completed by undergraduate students in pediatric and obstetrical courses.

RESULTS

The student (N = 106) mean score on OFER was 37.57 for chronic fatigue, 56.57 for acute fatigue, and intershift recovery was 56.57. No differences in chronic fatigue (P = .40), acute fatigue (P = .14), or intershift recovery (P = .35) were found between groups. Nursing students (79%) preferred 12-hour clinical shifts as compared to 21% who chose two 6-hour clinical.

CONCLUSIONS

No differences in chronic/acute fatigue or intershift recovery between a 12-hour clinical shift or two 6-hour clinical shifts were found. Nursing students preferred the one 12-hour clinical shift.