Long hours linked to patient deaths

 A study published in the January/February issue of Nursing Research links patient deaths with a lack of time off for nurses.
The study, “Nurses’ Work Schedule Characteristics, Nurse Staff and Patient Mortality,” examined the relationship between patient mortality and nurses’ work schedules. The researchers controlled for staffing levels (long known to be a factor in patient mortality) and found that longer shifts and lack of time off were independently associated with increased risk of patient death. Pneumonia deaths were more likely in hospitals where nurses reported long work hours. Death from abdominal aortic aneurysm was more likely when nurses reported a lack of time off of work. Congestive heart failure deaths appeared associated with nurses working while sick and heart attack deaths were positively related to what the researchers termed “weekly burden,” the number of hours per week or days in a row.

While previous studies (and nurses themselves) have linked nurses’ lack of sleep with poor patient outcomes, the current study suggests that 12-hour shifts or 7-on, 7-off schedules may not be the best for patients. The study also seems to emphasize the importance of time away from work for nurses.

In a previous series of articles, “Is It Time to Pull the Plug on 12-Hour Shifts?”, published in The Journal of Nursing Adminstration, study author Alison Trinkoff suggests a series of stategies to help minimize the risk of long shifts. Nurses’ time off must be maximized and protected, Trinkoff says. She recommends:

  • No overtime for 12-hour nurses
  • On-time departure. Leaving work on-time should be a guarantee, not an every-now-and-then thing.
  • On-the-job napping. Nurses who work 12-hour-shifts, especially night nurses, should be allowed short, 15-20 minute naps to refresh.
  • Real breaks. Nurses’ breaks should be sacrosanct and uninterrupted.

What do you think of the study? Do nurses need adequate time off to competently care of patients, or are 12-hour-and-beyond shifts no big deal?

Sources:

http://journals.lww.com/nursingresearchonline

http://journals.lww.com/jonajournal

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