Nurse Staffing Configurations and Nurse Absence Due to Sickness

Area of Science:

• Healthcare Management
• Nursing Workforce Studies
• Occupational Health

Background:

• High rates of work-related stress and sickness absence among nurses negatively impact healthcare system efficiency and productivity.
• Understanding the factors contributing to nurse sickness absence is crucial for improving workforce stability and patient care.

Purpose of the Study:

• To investigate the association between various nurse staffing configurations and sickness absence within hospital inpatient nursing teams.
• To identify specific staffing elements that may increase or decrease the likelihood of nurses taking sickness absence.

Main Methods:

• A retrospective longitudinal case-control study analyzed routinely collected data from 4 English general acute care hospitals.
• The study included 18,674 registered nurses (RNs) and nursing support (NS) staff across 116 units, examining data from April 2015 to February 2020.
• Key exposures included skill mix, temporary staffing, understaffing, long shifts, and work status (full-time/part-time).

Main Results:

• Higher proportions of RNs in the skill mix were associated with reduced odds of RN sickness absence (OR, 0.98 per 10% RN hours).
• Working exclusively long shifts (≥12 hours) in the prior week significantly increased the odds of sickness absence for RNs (OR, 1.26).
• Part-time RNs had higher sickness absence (OR, 1.09), with understaffing exacerbating absence for full-time RNs but not part-time staff.

Conclusions:

• Registered nurse (RN) understaffing is a significant risk factor for increased sickness absence in nursing teams.
• Adverse working conditions, including understaffing and long shifts, pose risks to nurse well-being and can worsen existing staff shortages.
• Optimizing nurse staffing configurations, particularly increasing the proportion of RNs and reducing long shifts, may mitigate sickness absence and improve workforce sustainability.