Running head: PATIENT SAFETY AND SHIFT LENGTH

Patient Safety and Shift Length

Andrea R. VanPortfliet
Ferris State University

PATIENT SAFETY AND SHIFT LENGTH

Patient Safety and Shift Length

Patient safety is very important in the hospital setting. Patients come to the hospital with
trust that they will be taken care of and get better. It is important that all employees are doing
everything possible to keep them safe and assist the patient in healing. Shift length is one topic
that has been discussed and researched. Are the patients being put in danger when the nurses and
doctors have been there for twelve hours and are exhausted and overworked? The goal is to
reduce the number of handovers, which is thought to reduce the amount of error made in patient
care (Griffiths, 2014). This is an excellent idea in theory, but some studies show that patient
safety decreases as shift length increases.
A normal shift length is eight hours, but the idea is to decrease handovers which is
thought to increase the safety for the patient. A handover is when one nurse leaves for the day
and another takes their place. They will discuss the patients diagnosis and any important
information needed to care for them, such as, ambulation, allergies, and much more. By having
twelve hour shifts, there is only two handovers per day, rather than three with the eight hour
shifts. Handovers can be dangerous when a nurse forgets to tell an important piece of
information to the next nurse on shift. The aim is to improve efficiency with no detrimental
effect on quality, (Griffiths, 2014). Although there are many benefits to the twelve hour shift
system, there is also a downside.
Nurses and doctors working twelve hour shifts are more likely to make more errors and
there is a decrease in patient safety and quality of care. There is an increased risk for infection in
the patients and can result in more injuries to the patient and the nurse, including falls, needle
sticks, and musculoskeletal injuries (Stimpfel, 2013). The quality of care decreases and the safety
of the patient is at risk. Increased fatigue results in unsatisfactory performance and can lead to
more errors. Employees working ten hour shifts or longer report a high level of fatigue nearing
the end of their shifts.

PATIENT SAFETY AND SHIFT LENGTH

A study done by The Association with Perceived Quality of Care and Patient Safety did a
cross-sectional survey of nurses with varying shift lengths, from eight to twelve or more hours.
They were asked how many hours were worked and how they felt their quality of care was for
their patients. Nurses who worked ten hour or greater shifts or overtime reported they had left
care undone or did not meet acceptable patient safety (Griffiths, 2014). Since patient care and
safety is a hospitals main concern, longer shifts and overtime can be damaging to the patient as
well as the hospital.
Nursing Theory
Jean Watsons theory of nursing can closely relate to this topic. The central theme of her
theory is that Nursing is concerned with promoting and restoring health, preventing illness, and
caring for the sick, (Taylor, p. 75). When the nurses reported that they left care undone, and are
not satisfied with their quality of care, they are not meeting this theory. They are not promoting
and restoring health when there is a greater risk for injury. When a nurse or doctor is fatigued
from a long day at work, they are not able to supply the care and respect that is needed to help
the patient heal.
Conclusion
Therefore, shift length of ten hours or longer are thought to be dangerous to the patient
because there is a decrease in the quality of care and safety for the nurse and to the patient.
Although there are less handovers than the eight hour shifts, the study shows that mistakes and
injuries are increased when a twelve hour shift or overtime is worked due to fatigue. In
conclusion, some studies show that patient safety and quality of care is being compromised when
a nurses shift exceed ten hours.

PATIENT SAFETY AND SHIFT LENGTH

References
Griffiths, P., Dall'Ora, C., Simon, M., Ball, J., Linquist, R., Rafferty, A., & Aiken, L. (2014,
October 15). Nurses Shift Length and Overtime in 12 European Countries. Retrieved
from PubMed.
Stimpfel, A., & Aiken, L. (2013, April 28). Hospital Staff Nurses' Shift Length Associated With
Safety and Quality of Care. Retrieved November 18, 2014, from PubMed.
Taylor, ., Lillis, ., LeMone, ., & Lynn, . (n.d.). Fundamentals of Nursing (Seventh ed., pp. 74-75).
Philadelphia, PA: Lippincott Williams & Wilkins.