nurses, the research team found that nurses working more than 12.5 consecutive
hours were three times more likely to make an error than nurses working
shorter hours. Working overtime at the end of a shift also increased the risk
of making an error.
The study, led by University of Pennsylvania nursing professor Ann Rogers,
will be published in the July/August issue of Health Affairs.
The study was conducted by giving nurses logbooks to track hours worked,
overtime, days off and sleep/wake patterns for 28 days. Participants were
asked to describe errors or near errors that might have occurred during their
Participants reported 199 errors and 213 near errors during the data-
gathering period. More than half of the errors (58 percent) involved
medication administration; other errors included procedural errors (18
percent), charting errors (12 percent), and transcription errors (7 percent).
Researchers found that most hospital nurses no longer work eight-hour day,
evening or night shifts. Instead, they may be scheduled for 12-hour, 16-hour
or even 20-hour shifts. Even when working extended shifts (less than or equal
to 12.5 hours), they were rarely able to leave the hospital at the end of
their scheduled shift. All participants reported working overtime at least
once during the data-gathering period, and one-third of the nurses reported
working overtime every day they worked.
"Both the use of extended shifts (greater than or equal to 12 hours) and
overtime documented in this study pose significant threats to patient safety,"
Rogers said. "In fact, the routine use of 12-hour shifts should be curtailed
and overtime -- especially overtime associated with 12-hour shifts -- should
The study was funded with a grant from the Agency for Healthcare Research
and Quality in Maryland. Scott and Rogers are conducting a correlating study
to research the work hours of critical care nurses.
Scott and Rogers are expected to speak before their respective state
legislatures on nurse fatigue and patient safety. Scott is also working with
the Michigan Nurses Association on patient safety legislation.
"We need to educate nurses and hospitals about fatigue," she said. "It's
a shared responsibility and both parties are accountable. This is a national
problem that will likely have a national effect."
Source: Grand Valley State University