Researchers have called for the routine implementation of 12-hour shifts to be avoided after they found long shift patterns lead to a higher risk of sickness absence for hospital nurses and healthcare assistants.
Led by researchers at the University of Southampton, the study concluded that higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals.
“This study shows objectively what happens after nurses have worked more long shifts”
They analysed data from over 600,000 shifts worked by 1,944 staff members across 32 general inpatient wards at an acute hospital in England from April 2012 to May 2015.
Funded by the National Institute for Health Research, the study found 38,051 shifts were lost due to sickness absence, corresponding to 8,090 distinct episodes.
The three-year study also revealed that 1,689 staff (86%) experienced at least one sickness episode. In this, the most common length of sickness episode lasted two days.
Last year, Nursing Times reported on findings from the study, but they have now been published in full in the Journal of Nursing Management.
Lead author Dr Chiara Dall’Ora, a research fellow in nursing workforce at Southampton, said: “The aim of this study was to examine the extent to which shift patterns are associated with sickness absence within a sample of nursing staff working on hospital wards.”
Though surveys in the past have suggested negative impacts from nurses working 12-hour shifts for both nurses and patients, he noted that his research was the first longitudinal study to look at the issue and further demonstrate the impact on nurses’ sickness rates.
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“Research into this issue in the past relied mostly on surveys of nurses to report their opinions of job satisfaction and quality but this study shows objectively what happens after nurses have worked more long shifts” said Dr Dall’Ora.
“As well as being bad for employees, such increases in sickness rates are likely to be costly”
This new study also established that when scheduled to work a shift of 12 hours or more, staff were 24% more likely to miss the shift due to sickness compared to those who were supposed to work shifts of eight hours or less, he said.
He added: “While occasional shifts of 12 hours or more in the past 7 days were not significantly associated with more sickness absence, when staff worked a higher proportion of shifts of 12 hours or more, sickness rates increased, with the highest odds for those working more than three quarters of their shifts as 12 hours or more shifts.”
The study also found that when more than 75% of shifts worked across a seven-day period were 12 hours long, the odds of both a short-term and long-term sickness episode were increased compared to working none.
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Professor Peter Griffiths, a co-author of the paper and chair of Health Services Research at the University of Southampton, reiterated how both long and short-term sickness was associated with staff working more long shifts.
“As well as being bad for employees, such increases in sickness rates are likely to be costly and may undermine a key motivation for introducing the 12-hour shift pattern – organisational efficiency,” he said.
Dr Dall’Ora added: “In the current context and in light of previous findings from our work and that of others, our research suggests that, while occasional 12-hour shift work may not have adverse consequences, working higher proportions may lead to higher sickness absence.
“Therefore, nurse managers should question routine implementation of long shift patterns, especially if this is based on assumed cost savings,” he said.
The study also included researchers from the University of Portsmouth, Portsmouth Hospitals NHS Trust, and Italy’s Libera Università Maria Ss Assunta. Their findings have been published in the Journal of Nursing Management.