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A Comparison of Shift Length and Nursing and Quality Outcomes in Acute Inpatient Mental Health Units
Rebecca J Beckman1, Scott Hutton, Elizabeth Czekanski
1Author Affiliations: Chief Nurse and Director of Quality (Ms Beckman), Mental Health Care Line, Cincinnati VA Medical Center, Ohio; Training Coordinator (Ms Beckman), Office of Change Management, in support of Office of Electronic Health Record Modernization, Washington, DC; Director of Operations (Dr Hutton), Workplace Violence Prevention Program, VHA Central Office, Office of Mental Health and Suicide Prevention, Washington, DC; Associate Director Mental Health, Mental Health Clinical Nurse Advisor (Dr Czekanski), Office of Nursing Services, Veteran's Health Administration Central Office, Washington, DC; Adjunct Professor (Dr Czekanski), Carlow University, Pittsburgh, Pennsylvania; Director of Educations and Informatics (Dr Vance), Workplace Violence Prevention Program, VHA Central Office, Office of Mental Health and Suicide Prevention; and Investigator (Dr Mohr), Center for Healthcare, Organization and Implementation Research, VA Boston Healthcare System; and Research Assistant Professor (Dr Mohr), Boston University School of Public Health, Massachusetts.
Objective:
This study compared outcomes between units that used either 8-hour or 12-hour shifts in acute inpatient mental health units.
Background:
Most hospitals continue to use 12-hour shifts despite research suggesting safety concerns with longer shifts. There is a gap in the literature on effects of shift lengths on nursing and patient outcomes in acute mental health units.
Methods:
This study is a retrospective comparative analysis of cross-sectional data between 32 inpatient mental health units that used 8-hour versus 12-hour shifts. Independent samples t test was used to examine differences on several staffing, quality, and safety measures.
Results:
A moderate effect size was found between the groups in quality and safety measures involving patient disruptive behaviors, with the 8-hour group having more desirable outcomes.
Conclusions:
Nurse leaders in acute mental health units should consider the impacts of shift length on quality and safety when determining staffing patterns. More research is needed to evaluate correlations or causality.
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