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12 小时轮班与急性医院护理资源使用的关联:纵向研究。

Association between 12-hr shifts and nursing resource use in an acute hospital: Longitudinal study.

机构信息

National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (Wessex), University of Southampton, Southampton, UK.

Faculty of Health Sciences, University of Southampton, Southampton, UK.

出版信息

J Nurs Manag. 2019 Apr;27(3):502-508. doi: 10.1111/jonm.12704. Epub 2018 Nov 21.


DOI:10.1111/jonm.12704
PMID:30461112
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7380133/
Abstract

AIM: To evaluate whether ≥12-hr shifts are associated with a decrease in resource use, in terms of care hours per patient day and staffing costs per patient day. BACKGROUND: Nurses working long shifts may become less productive and no research has investigated whether potential cost savings are realized. METHOD: A retrospective longitudinal study using routinely collected data from 32 wards within an English hospital across 3 years (1 April 2012-31 March 2015). There were 24,005 ward-days. Hierarchical linear mixed models measured the association between the proportion of ≥12-hr shifts worked on a ward-day, care hours per patient day and staffing costs per patient day. RESULTS: Compared with days with no ≥12-hr shifts, days with between 50% and 75% ≥12-hr shifts had more care hours per patient day and higher costs (estimate for care hours per patient day: 0.32; 95% CI: 0.28-0.36; estimate for staffing costs per patient day: £8.86; 95% CI: 7.59-10.12). CONCLUSIONS: We did not find reductions in total care hours and costs associated with the use of ≥12-hr shifts. The reason why mixed shift patterns are associated with increased cost needs further exploration. IMPLICATIONS FOR NURSING MANAGEMENT: Increases in resource use could result in additional costs or loss of productivity for hospitals. Implementation of long shifts should be questioned.

摘要

目的:评估≥12 小时班次是否与患者护理时数和患者日人力成本的减少有关。

背景:长时间轮班的护士可能效率降低,但目前还没有研究调查是否可以实现潜在的成本节约。

方法:这是一项使用英格兰一家医院 32 个病房的常规数据进行的回顾性纵向研究,研究时间跨度为 3 年(2012 年 4 月 1 日至 2015 年 3 月 31 日),共涉及 24005 个病房日。采用分层线性混合模型,分析病房日≥12 小时班次比例与患者护理时数和患者日人力成本之间的关系。

结果:与没有≥12 小时班次的日子相比,有 50%至 75%≥12 小时班次的日子患者护理时数更多,成本更高(患者护理时数的估计值:0.32;95%CI:0.28-0.36;患者日人力成本的估计值:£8.86;95%CI:7.59-10.12)。

结论:我们没有发现与使用≥12 小时班次相关的总护理时数和成本减少。需要进一步探讨混合班次模式与成本增加之间的关系。

启示:资源使用的增加可能会导致医院增加成本或降低生产力。应质疑长时间轮班的实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4aa/7380133/26f0d500645d/JONM-27-502-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4aa/7380133/26f0d500645d/JONM-27-502-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4aa/7380133/26f0d500645d/JONM-27-502-g001.jpg

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Association between 12-hr shifts and nursing resource use in an acute hospital: Longitudinal study.

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[5]
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[6]
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[7]
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[8]
Nurses' experiences and preferences around shift patterns: A scoping review.

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本文引用的文献

[1]
Are long nursing shifts on hospital wards associated with sickness absence? A longitudinal retrospective observational study.

J Nurs Manag. 2018-7-5

[2]
Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study.

Int J Nurs Stud. 2017-8-24

[3]
Unregistered health care staff's perceptions of 12 hour shifts: an interview study.

J Nurs Manag. 2017-10

[4]
Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures.

BMC Nurs. 2017-5-25

[5]
Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development.

Int J Nurs Stud. 2016-3-30

[6]
Characteristics of shift work and their impact on employee performance and wellbeing: A literature review.

Int J Nurs Stud. 2016-5

[7]
Association of 12 h shifts and nurses' job satisfaction, burnout and intention to leave: findings from a cross-sectional study of 12 European countries.

BMJ Open. 2015-8-23

[8]
Nurses' shift length and overtime working in 12 European countries: the association with perceived quality of care and patient safety.

Med Care. 2014-11

[9]
Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.

Lancet. 2014-2-26

[10]
Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital.

J Nurs Manag. 2014-3-3

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