12 Hour Nursing Practice Summary

Mulloy, D. F., & Hughes, R. G. (2008). Patient safety & quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

Over the last several years, a wide variety of health care organizations have been facing a number of challenges. This is because of pressures associated with: rising costs, increasing demands and larger numbers of patients. For many facilities this has created a situation where patient safety issues are often overlooked. This is because the staff is facing tremendous amounts of pressure, long hours and more patients. The combination of these factors has created a situation where a variety of hospitals need to improve their patient safety procedures. In the case of Sharp Memorial Hospital, they are focused on addressing these issues through different strategies. To fully understand how they are able to achieve these objectives requires looking at: specific ways the organization has responded to the crisis in medical errors, their definition of patient safety, the causes of errors, systematic barriers and transformations that have been adopted. Together, these different elements will provide the greatest insights as to how the facility is coping with the crisis in patient safety.

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

In the nursing profession, especially when working in a hospital, it is not uncommon to have 12-hour nursing shifts,

Purpose: The purpose of this speech is to inform my audience about the importance of safe nurse staffing that can help improve patient satisfaction, decrease patient complications, reduce nurse fatigue, improve nurse retention, decrease patient mortality, and reduce medical and medication error.

The continued shortage of registered nurses will be a catalyst for the increasing stress placed upon practicing nurses now and in the future. Mandatory overtime has been an incessant problem within the nursing profession. When lives are at risk, alertness is a critical part of a nurse’s job performance. Fatigue impairs one’s judgement directly affecting patient and nursing safety or outcomes. This author’s typical six week work schedule consists of eighteen-twelve hour shifts, nine “required” twelve hour call shifts, and three-four hour back-up shifts. A nurse that accepts a patient assignment in the operating room cannot legally or ethically leave when their shift has ended without proper relief. Inevitably, without proper staffing departure is not an

Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role. Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature

According to the Safe Nursing and Patient Care Act, requiring nurses to work overtime would be “strictly limited” (ANA, 2005). This bill has been proposed in response to the nursing shortage within the United States. This is imperative to maintaining the quality of nursing care and patient safety that we provide to our patients. The bill proposes that nurses and licensed practical nurses should not be forced to work overtime, or receive retaliation/discrimination due to refusal (ANA, 2005). In addition, the bill proposes that more studies be done to learn the

Patients in a hospital and/or healthcare facilities have to be cared for all day and all night, everyday of the week by nurses. The usual way to fulfill this need is to divide up the day into three 8-hour shifts. Different shifts have been put into place to help improve nurse satisfaction, decrease the nursing shortage and save the hospital money. The 24-hour day is made up of two 12-hour shifts; 12 hours in the day and 12 hours at night. There has been quite an ongoing debate over the years regarding this issue of nurses working over 8 hours in a single day. Many people, such as hospital nursing administrators, have reason to believe that working long hour shifts causes more errors in

For some nurses, mandatory overtime can be an advantage due to financial instability but mostly mandatory overtime can cause fatigue, burnout, injuries, errors, inadequate sleep and deficits in performance. According to research working long hours which consists more than 40 hours a week or over 12 hours a day leads to an increased medication errors and patient mortality. The probability of making medication errors increases tremendously when nurses work longer than 12.5 hours a day. During surveys regarding reasons of overtime, 60 % of nurses stated that overtime was obligatory as part of their job, 29 % of nurses stated that they volunteered and 41% of nurses stated that they were “on call hours” (Bae, 2012)

The first topic focused on in an article by Stimpfel et al. (2012) looked at the effect of longer shifts on nurses. Compared to the past, nurses are working twelve-hour shifts, instead of eight-hour shifts. The reason for these changes in shift lengths is for it to allow for nurses to have more flexibility in their schedules and to give them more time at home. This study revealed that the hours actually worked by nurses are unpredictable. Due to the fluctuations of patient needs and unanticipated staffing on the unit, leads to nurses having to work over their scheduled time (Stimpfel et al. 2012). This study also pointed out that there are no national policies for nurses that dictate the maximum number of hours a nurse can work. Nurses often end up working several hours over their shift because they feel forced into working those hours and thereby leading to burnout.

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

173). For many workers the schedule was an outlet for discontent; this is because many were forced to work six days a week, some weeks without a day off (Lynaugh, 2000). Nowadays, “60% of U.S. nurses surveyed work at least one type of overtime […] 54% work less than 12 hours a week overtime and 46% work 12 hours or more per week” (Wheatley, 2017, p.213). In addition, traditionally nurse’s shifts were eight hours long; however, in 1980’s -1990’s when structural changes in healthcare occurred and cost containment was put in, nurses started working 12-hour shifts. Because it was less expensive to work 12-hours shifts, instead of 8-hours, this became prevalent in most hospitals in the United States (Weathley, 2017).

Issues related to a lack of patient safety have been going on for a lot of years now. Throughout the first decade of the 21st century, there has been a national emphasis on cultivating patient safety. Patient safety is a global issue, that touches countries at all levels of expansion and is one of the nation's most determined health care tests. According to the Institute of Medicine (1999), they have measured that as many as 48,000 to 88,000 people are dying in U.S. hospitals each year as the result of lapses in patient safety. Estimates of the size of the problem on this are scarce particularly in developing countries; it is likely that millions of patients worldwide could suffer disabling injuries or death every year due to unsafe medical care. Risk and safety have always been uninterruptedly been significant concerns in the hospital industry. Patient safety is a very much important part of our health care system and it really

One of the many goals of the nursing profession is to provide high-quality, safe patient care. There are many responsibilities that come with a nursing career and when the nurse to patient ratio increases, there is a possibility that it may hinder the safe care that patients deserve, and this may result in negative patient outcomes and level of satisfaction. Staffing is one of the many issues that healthcare facilities face. In many facilities, there never seems to be enough nurses per shift to provide high quality, thorough patient care which often leads to burnt out staff, and frustrated patients and families. This review discusses the findings of quantitative studies and one systematic review that involves patient outcomes in relation to nurse staffing.