Differences between weekend and weekday nurse work environments and patient outcomes: a focus group approach to model...

This focus group study was exploratory and descriptive.

To identify differences between weekend and weekday nurse work environments that might explain higher rates of neonatal mortality among babies born on weekends.

The convenience sample consisted of 14 nurses from labor and delivery and neonatal intensive care units in 4 hospitals in 3 Texas cities.

Focus group sessions were audiotaped and then transcribed verbatim. Responses were analyzed inductively and then compared to the model of Organizational Support of Nursing Care presented by Aiken, Clarke, and Sloane.

The focus group responses fit the model moderately well. However, there were additional constructs found in the data that went beyond the model. Additional constructs included patient need/demand, nurse characteristics/skill level, and external motivating and inhibiting factors.

Nurses identified significant differences between weekend and weekday work environments such as less direct supervision and problems getting physician backup for emergencies on weekends. They gave examples where they felt weekend work environments resulted in both negative and positive patient outcomes. The nurses made no real distinction between night shift and weekend environments. The knowledge gained can be used to design effective strategies to improve the process of care and patient outcomes on weekends.