The association between 12-hour shifts and nurses-in-charge's perceptions of missed care and staffing adequacy: a retrospective cross-sectional observational study

Shift Work, Psychological Health Disorders, and Job Security Among Nurses: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Shift work is prevalent among nurses, often leading to adverse psychological effects, such as fatigue, depression, anxiety, and stress. Understanding how shift work contributes to psychological health disorders can help healthcare organizations identify critical areas where support should be offered. This study aimed to determine the relationships between shift work, psychological health disorders, and job security among nurses in Saudi Arabia.

METHODS

This cross-sectional study included 163 nurses, recruited via convenience sampling. The participants completed an online questionnaire that assessed demographic variables, psychological disorders, fatigue, and job security. The data were analyzed using descriptive statistics as well as bivariate analyses to explore relationships between variables.

RESULTS

Most participants (73%) worked 12 h shifts, and 67.5% reported fair sleep quality. We found significant correlations among shift work, fatigue, and common psychological disorders. Significant differences were also observed for fatigue (p = 0.007) and depression (p = 0.008). Both nationality (p < 0.001) and shift work (p = 0.015) were correlated with anxiety. Similarly, significant differences were found for nationality (p = 0.001) and shift work (p = 0.002) regarding stress.

CONCLUSIONS

These findings underscore the psychological challenges faced by nurses related to shift work, emphasizing the importance of addressing fatigue and mental health. Healthcare organizations should implement strategies to enhance job security and support nurses' well-being to ultimately improve both nurse satisfaction and patient care outcomes. Further research is warranted to explore effective interventions and the long-term effects of shiftwork on nursing professionals.

Bottleneck factors impacting nurses' workflow and the opportunity to prioritize improvement efforts: factor analysis

PURPOSE

Minimizing delays in delivering nursing care is paramount for enhancing the overall quality of care. Certain bottleneck variables restrict the workflow of nurses, resulting in extended shift times. This study is designed to pinpoint and analyze the principal factors contributing to bottleneck issues in nursing workflow, to direct improvement endeavors. This study seeks to provide insights into the key variables contributing to nurses' extended shift times, with the ultimate goal of prioritizing efforts for improvement.

METHODS

A descriptive multicenter cross-sectional study was conducted. A scale was developed for this study by the authors after conducting a literature review, subsequently validated, and its reliability was assessed.

RESULTS

Among the 31 bottleneck variables, 29 were retained under three persistent bottleneck factors: (1) Nurse staffing- This pertains to the availability of sufficient nursing staff at all times across the continuum of care; (2) Working environment and quality of care-This refers to the availability of necessary skills and resources for nurses to perform their duties effectively and; (3) Medical devices- This factor concerns the availability of fully functional medical devices required for providing care.

CONCLUSION

Efforts aimed at enhancing the overall healthcare system should concentrate on addressing persistent bottleneck factors. This may involve the implementation of a healthcare workforce management system, the establishment of standards for a conducive and supportive working environment, and the utilization of a standardized system for the management of medical equipment. The outcomes of this study can be utilized by nurses and policymakers to devise comprehensive strategies for improvement.

Working Hours Associated with the Quality of Nursing Care, Missed Nursing Care, and Nursing Practice Environment in China: A Multicenter Cross-Sectional Study

Aim

The aim of the study was to examine the effect of the length of working hours on missed nursing care, quality of nursing care, and perceptions of the nursing practice environment.

Methods

A multicenter cross-sectional investigation using online questionnaires was conducted from April 2 to May 10, 2022, in twenty nine hospitals (13 Level-III hospitals and 16 Level-II hospitals). We collected data on the working hours of nurses and nurse-reported outcomes, including missed nursing care, quality of nursing care, and nursing practice environment. Restricted cubic spline (RCS) regression models were used to examine relationships between the hours per shift and nurse-reported outcomes.

Results

We investigated 12,703 nurses with a response rate of 97.33%. Nurses worked on average 7.72 (SD = 1.16) hours on the day shift and 8.92 (SD = 2.20) hours on the night shift, respectively. On the day shift, working 7.5 hours shift showed minimal missed nursing care; meanwhile, working 7-7.5 hours were correlated with the highest satisfaction of the nursing practice environment and better quality of nursing care. On the night shift, the highest missed nursing care was found for a working duration of 12 hours to the working 7 hours, with the lowest satisfaction while better quality was observed. The percentage of nurses who reported working overtime was 30.33%. Nurses who worked overtime reported lower satisfaction and poorer quality of nursing care on all shifts; moreover, working overtime showed the positive correlation to missed nursing care on the day shift, while on night shift was not statistically significant.

Conclusion

Positive outcomes were observed for nurses who reported working 7-7.75 hours on the day shift and 12 hours (no more than 15 hours) on the night shift. Implications of Nursing Management. The results reemphasized the need for managers to reduce the working hours, overtime work, and the frequency of the night shift.

Development of a new personalized staff-scheduling method with a work-life balance perspective: case of a hospital

Burnout rates and dissatisfaction among healthcare workers remain high due to long working hours. One possible solution to this problem is to let them choose their weekly working hours and starting times in order to achieve a work-life balance. Moreover, a scheduling process that responds to changing healthcare demands at different times of the day should increase work efficiency in hospitals. In this study, a methodology and software were developed to schedule hospital personnel, taking into account their preferences regarding working hours and starting time. The software also allows the hospital management to determine the number of staff needed at different times of the day. Three methods and five working-time scenarios characterized by different divisions of working time are proposed to solve the scheduling problem. The Seniority score Priority assignment Method appoints personnel prioritizing seniority, whereas the newly developed Balanced and Fair assignment Method and Genetic Algorithm Method aim for a more nuanced distribution. The methods proposed were applied to physicians in the internal diseases department in a specific hospital. Weekly/monthly scheduling of all employees was carried out with the software. The results of scheduling factoring in work-life balance, and the performances of algorithms are shown for the hospital where the application was trialled.

The Factor Associated with Missed Nursing Care in Hospital: A Systematic Review

Background:  Patient safety is a major concern in the healthcare industry worldwide. Increasing patient safety is critical for avoiding negative outcomes in nursing care and achieving goals at the desired level of quality. One of the indicators of this quality care given to patient is known as missed care. Aim: Aims of this study to explore the factors influencing missed care in order to improve the quality of nursing care. Methods: This study is a systematic review that explores the factors influencing missed nursing care in hospitals. Meanwhile, the literature search was carried out in the CINAHL Pubmed, Ebsco, Science Direct, Proquest, Willey, Sage from 2017 to 2021. Results: The results from six databases (n=3702) were sorted into 22 collected articles which include 18 quantitative, 2 qualitative, and 2 mixed methods. These findings highlighted three factors that influence missed nursing care: a lack of staffing, nurse competency, and the working environment. Conclusion: The factors that  contribute with missed nursing care in hospitals include lack of nurse staff, competency, and work environment. As a result, the nursing manager's critical role is to create adequate nursing staff, improve their competency, and foster a positive work environment. Keywords: missed nursing care, lack of staffing, nurse competency,  working environment