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Nurses' work schedule characteristics, nurse staffing, and patient mortality.
Nurs Res. 2011 Jan-Feb; 60(1):1-8.NR

Abstract

BACKGROUND

Although nurse staffing has been found to be related to patient mortality, there has been limited study of the independent effect of work schedules on patient care outcomes.

OBJECTIVE

To determine if, in hospitals where nurses report more adverse work schedules, there would be increased patient mortality, controlling for staffing.

METHODS

A cross-sectional design was used, with multilevel data from a 2004 survey of 633 nurses working in 71 acute nonfederal hospitals in North Carolina and Illinois. Mortality measures were the risk-adjusted Agency for Healthcare Research and Quality Inpatient Quality Indicators, and staffing data were from the American Hospital Association Annual Survey of hospitals. Principal components analysis was conducted on the 12 work schedule items to create eight independent components. Generalized estimating equations were used to examine the study hypothesis.

RESULTS

Work schedule was related significantly to mortality when staffing levels and hospital characteristics were controlled. Pneumonia deaths were significantly more likely in hospitals where nurses reported schedules with long work hours (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.17-1.73, p < .01) and lack of time away from work (OR = 1.24, 95% CI = 1.03-1.50, p < .05). Abdominal aortic aneurysm was also associated significantly with the lack of time away (OR = 1.39, 95% CI = 1.11-1.73, p < .01). For patients with congestive heart failure, mortality was associated with working while sick (OR = 1.39, 95% CI = 1.13-1.72, p < .01), whereas acute myocardial infarction was associated significantly with weekly burden (hours per week; days in a row) for nurses (OR = 1.33, 95% CI = 1.09-1.63, p < .01).

DISCUSSION

In addition to staffing, nurses' work schedules are associated with patient mortality. This suggests that work schedule has an independent effect on patient outcomes.

Authors+Show Affiliations

School of Nursing, University of Maryland, Baltimore, MD 21201, USA. trinkoff@son.umaryland.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21127449

Citation

Trinkoff, Alison M., et al. "Nurses' Work Schedule Characteristics, Nurse Staffing, and Patient Mortality." Nursing Research, vol. 60, no. 1, 2011, pp. 1-8.
Trinkoff AM, Johantgen M, Storr CL, et al. Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nurs Res. 2011;60(1):1-8.
Trinkoff, A. M., Johantgen, M., Storr, C. L., Gurses, A. P., Liang, Y., & Han, K. (2011). Nurses' work schedule characteristics, nurse staffing, and patient mortality. Nursing Research, 60(1), 1-8. https://doi.org/10.1097/NNR.0b013e3181fff15d
Trinkoff AM, et al. Nurses' Work Schedule Characteristics, Nurse Staffing, and Patient Mortality. Nurs Res. 2011 Jan-Feb;60(1):1-8. PubMed PMID: 21127449.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nurses' work schedule characteristics, nurse staffing, and patient mortality. AU - Trinkoff,Alison M, AU - Johantgen,Meg, AU - Storr,Carla L, AU - Gurses,Ayse P, AU - Liang,Yulan, AU - Han,Kihye, PY - 2010/12/4/entrez PY - 2010/12/4/pubmed PY - 2011/1/15/medline SP - 1 EP - 8 JF - Nursing research JO - Nurs Res VL - 60 IS - 1 N2 - BACKGROUND: Although nurse staffing has been found to be related to patient mortality, there has been limited study of the independent effect of work schedules on patient care outcomes. OBJECTIVE: To determine if, in hospitals where nurses report more adverse work schedules, there would be increased patient mortality, controlling for staffing. METHODS: A cross-sectional design was used, with multilevel data from a 2004 survey of 633 nurses working in 71 acute nonfederal hospitals in North Carolina and Illinois. Mortality measures were the risk-adjusted Agency for Healthcare Research and Quality Inpatient Quality Indicators, and staffing data were from the American Hospital Association Annual Survey of hospitals. Principal components analysis was conducted on the 12 work schedule items to create eight independent components. Generalized estimating equations were used to examine the study hypothesis. RESULTS: Work schedule was related significantly to mortality when staffing levels and hospital characteristics were controlled. Pneumonia deaths were significantly more likely in hospitals where nurses reported schedules with long work hours (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.17-1.73, p < .01) and lack of time away from work (OR = 1.24, 95% CI = 1.03-1.50, p < .05). Abdominal aortic aneurysm was also associated significantly with the lack of time away (OR = 1.39, 95% CI = 1.11-1.73, p < .01). For patients with congestive heart failure, mortality was associated with working while sick (OR = 1.39, 95% CI = 1.13-1.72, p < .01), whereas acute myocardial infarction was associated significantly with weekly burden (hours per week; days in a row) for nurses (OR = 1.33, 95% CI = 1.09-1.63, p < .01). DISCUSSION: In addition to staffing, nurses' work schedules are associated with patient mortality. This suggests that work schedule has an independent effect on patient outcomes. SN - 1538-9847 UR - https://www.unboundmedicine.com/medline/citation/21127449/Nurses'_work_schedule_characteristics_nurse_staffing_and_patient_mortality_ L2 - https://doi.org/10.1097/NNR.0b013e3181fff15d DB - PRIME DP - Unbound Medicine ER -