Nurse shift patterns, staffing and their association with perceived workload: Sequence analysis of multicentre data

Area of Science:

• Nursing
• Healthcare Management
• Occupational Health

Background:

• Shift work is common in hospitals, but its impact on nurses' workload, health, and patient safety is understudied.
• Specific shift patterns and staffing levels can disproportionately affect nurses' perceived workload.

Purpose of the Study:

• To characterize nurses' shift work patterns in acute care hospitals.
• To investigate the association between shift work patterns, staffing levels, and perceived workload among nurses.

Main Methods:

• Secondary analysis of a cross-sectional, multicentre study involving 1962 registered nurses across 26 Swiss acute care hospitals.
• Sequence analysis and clustering (Optimal Matching) to identify shift patterns.
• Calculation of patient-to-nurse ratio and use of NASA-Task Load Index for workload assessment.

Main Results:

• Identified three distinct shift patterns among nurses.
• Low staffing, overtime (especially in the last shift), longer shift length, and working more days were associated with higher perceived workload.
• Backward rotations, quick returns, and working >5 consecutive days were infrequent.

Conclusions:

• Staffing and scheduling decisions significantly contribute to nurses' perceived workload.
• Prioritizing staffing and scheduling improvements, such as reducing overtime and shift length, is crucial for reducing workload and improving healthcare.
• Future research should utilize electronic rosters and real-time data for more accurate assessments.