Determinants of Night-Shift Scheduling Quality for Nurses in Korea: A Multilevel Approach

Area of Science:

• Nursing
• Healthcare Management
• Organizational Psychology

Background:

• Night-shift work poses challenges for nurses, potentially increasing medical error rates.
• Identifying factors influencing night-shift scheduling quality is crucial for improving nurse well-being and patient safety.

Purpose of the Study:

• To analyze individual and organizational factors affecting the quality of night-shift scheduling for nurses.
• To provide evidence for policy-level interventions aimed at enhancing nurse shift work environments.

Main Methods:

• Secondary data analysis of nurses' roster schedules and unit manager questionnaires.
• Multilevel analysis of a nested dataset comprising 1566 nurses across 81 wards.
• Examination of individual-level (e.g., gender) and organizational-level (e.g., nurse-to-patient ratio, ward type) predictors.

Main Results:

• Higher quality night-shift scheduling was associated with female nurses.
• Organizational factors significantly predicting quality included the number of night-shift-only RNs, ward type, and the night-duty RN-to-patient ratio.
• Comprehensive Nursing and Care Service (CNCS) wards and those with higher RN-to-patient ratios demonstrated better scheduling quality.

Conclusions:

• Ward staffing composition and nurse-to-patient ratios are key determinants of night-shift scheduling quality.
• Governmental support, as seen in CNCS wards and policies for night-shift-only RNs, positively impacts nurses' shift work environments.
• Policy interventions are recommended to improve the quality of nursing shift work and mitigate associated burdens.