Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using...

Area of Science:

• Healthcare Management
• Nursing Practice
• Patient Safety

Background:

• Extended nursing shifts (12+ hours) are prevalent in hospitals.
• Previous research often relied on self-reported data and focused on general hospital settings.
• The safety implications of long nursing shifts in mental health and community settings require objective investigation.

Purpose of the Study:

• To determine the association between 12+ hour nursing shifts and patient incident rates.
• To analyze the impact of long shifts on various incident types including falls, self-injury, and medication errors.
• To provide evidence-based recommendations regarding shift length policies in mental health and community care.

Main Methods:

• Longitudinal study utilizing routinely collected data from two NHS trusts (April 2018 - March 2021).
• Analysis of 898,143 nursing shifts and 38,373 patient incidents at the ward-day level.
• Application of negative binomial and Poisson mixed-effects models to assess the relationship between long shift proportion and incident rates.

Main Results:

• An increasing proportion of 12+ hour shifts correlated with a higher rate of patient incidents.
• Incident rates rose sharply when long shifts constituted over 70% of total shifts.
• Self-injury incidents showed a steady increase with a higher proportion of long shifts.

Conclusions:

• The study found a significant relationship between extended nursing shifts and increased patient incidents.
• Findings suggest that policies mandating long nursing shifts should be discouraged to enhance patient safety.
• Further research may explore optimal shift lengths and staffing models in specialized mental health and community care settings.