Shift work and hospital employees: A descriptive multi-site study.

BACKGROUND: Hospitals staff with 12-hour and other shift work patterns to account for daily and seasonal workload requirements. Research in healthcare and industries requiring shift work suggests there may be negative health consequences to the workers related to fatigue and other factors. Due to the 24/7 nature of healthcare, it is important to understand the impact of shift work on employees. OBJECTIVES: The objectives of this study were to investigate how shift work impacts satisfaction with time for social and home activities, based on the Social and Domestic Survey, and chronic fatigue. In addition, an exploration of drowsy driving was undertaken. DESIGN AND SETTING: This study was a multi-site, descriptive survey study, conducted in 4 acute care hospitals in one metropolitan area in the central United States. PARTICIPANTS: Participants included healthcare workers in five 24/7 departments: nursing, respiratory therapy, laboratory, radiology and pharmacy. METHODS: Measures included demographics, work characteristics, and scales including the: Social and Domestic Survey, Circadian Type Inventory, and Chronic Fatigue Scale along with data regarding drowsy driving and automobile accidents/near misses. Data were analyzed using descriptive statistics for sample characteristics. An exploratory factor analysis was conducted on the Social and Domestic Survey. Group differences were tested using Mann-Whitney U tests and regression analyses. RESULTS: The sample included 1563 subjects (24% RR). The mean age was 40 years. Nursing comprised 77% of the sample, 88% were female, 85% were in a direct patient care role, 67% worked day shift, and 49% worked 12-hour shifts. Pay was important for working night shift, but home life was important for day shift. Night shift (p<0.001) and 12-hour shift workers (p<0.001) had higher chronic fatigue. However, after controlling for other factors, working night shift remained a significant predictor of chronic fatigue and lower satisfaction with time for daily tasks and family/social life, whereas working 12-hour shifts predicted higher satisfaction with daily tasks and periodic life activities. Thirty-five percent of workers reported altering their driving behavior at least half the time due to drowsy driving and 19% had an automobile accident or near miss due to drowsy driving. CONCLUSIONS: Findings suggest that night and long shifts can have negative effects on fatigue, family, and social life. Drowsy driving and accidents/near misses frequently occur due to drowsy driving. Leaders should continue to study the 24/7 work environment and test measures to improve the safety of shift workers.

Developing and testing a clinical information system evaluation tool: prioritizing modifications through end-user input.

OBJECTIVE: The objectives were to develop and validate the Information System Evaluation Tool (ISET), use feedback to modify the institution's clinical information system (CIS), and determine the modifications' success. BACKGROUND: The ability of a CIS to increase patient safety and care quality is dependent on its systems and processes. A survey was needed to provide the specificity necessary to make meaningful system improvements. METHODS: The ISET was pilot tested and revised before being administered before implementation of the CIS. It was administered at 2 times after implementation. The ISET was revised after analysis of the results, and comparisons were made between the times. RESULTS: The ISET is a valid and reliable instrument. Perceptions of the CIS initially decreased, but had significantly improved by 16 months after implementation. CONCLUSIONS: End-users must be convinced that the CIS supports their practice and improves care for adoption to be successful. The ISET measures these perceptions and highlights areas for improvement.

Differentiating the workplace needs of nurses by academic preparation and years in nursing.

Questions surrounding the optimal level of academic preparation for nurses entering the workforce appear to be nearing consensus. However, in most organizations, the existing nursing workforce includes nurses of various ages, amounts of experience, and levels of academic preparation. All nurses serve an important role in caring for patients. The objective of this study was to determine if differences in work environment perceptions exist for nurses with different levels of academic preparation but similar years of experience in nursing. Mean values of work environment perceptions were compared between associate degree nurses and bachelor of science nurses with equivalent years in clinical practice using univariate statistics. Bachelor of science nurses reported similar or more positive work environment perceptions across all levels of professional experience as compared with associate degree nurses. The largest difference in perceptions between the two groups was seen in nurses with more than 15 years of professional experience. In this group, bachelor of science nurses reported more positive perceptions of peer support, unit support, workload, and overall nursing satisfaction. Intent to stay was not different between the groups considered. The results of this study suggest that efforts to expand nurses' access to baccalaureate programs may have positive implications for professional nursing and the work environment.