Feasibility of collecting and using nursing shift patterns data in acute, community and mental health wards

Principal Investigator: Dr Chiara Dall’Ora

Team members: Dr Chiara Dall'Ora (Senior Research Fellow in Nursing Workforce, School of Health Sciences, University Of Southampton),  Professor Peter Griffiths (Chair of Health Services Research, School of Health Sciences, University of Southampton), Ms Nicky Sinden (Head of Nursing Workforce at Portsmouth Hospitals NHS Trust), Dr Sarah Williams (Associate Director of Research & Improvement, and Academy Lead at Solent NHS Trust), Ms Catherine Smith (Associate Director Workforce Research and Innovation, Southern Health NHS Foundation Trust), Professor Jane Ball (Deputy Head of School (Research & Enterprise), School of Health Sciences, University of Southampton), Dr David Culliford (Senior Medical Statistician, School of Health Sciences, University of Southampton), Mr Anthony Austin, PPI contributor

Start: 1 October 2020  Ended: 31 December 2022

Partners:

University of Southampton, Portsmouth Hospitals NHS Trust, Solent NHS Trust, Southern Health NHS Foundation Trust. UNISON, Royal College of Nursing

Lay summary

Nurses and care assistants form the largest group of NHS staff. Most work in services that provide care across 24 hours of the day. Research indicates that the organisation of nursing shift patterns might affect the productivity of health services. The introduction of long shifts in nursing was offered as a strategy to maintain service levels while eliminating overlaps. However, research has found that long shifts are associated with higher rates of sickness and poorer patient care. So far, there has been little research exploring individual factors influencing shift work experiences among nurses, and research has been largely confined to acute hospitals.

What did we learn/find out?

• Working long shifts (12-h or longer) leads to more burnout for nursing staff

• Having little choice around shift patterns leads to more nursing burnout

• Nurses working 12-h shifts reported lower choice around shift patterns than nurses working 8-h shifts

• When wards in Mental Health and community hospitals operated with high proportions of long shifts, there were higher rates of patient incidents

• This was particularly the case for self-harm incidents and incidents of patient disruptive behaviour

What difference can this new knowledge make?

• It will help nurse managers and those in charge of creating nursing rotas

• It will help nurses working in inpatient settings choose their shift patterns

• It will keep patients safer because they will be cared for by nurses who are less tired

Why is this important for patients, health and care providers and policy makers ?

• Nursing burnout is at an all time high, and we provided evidence that can help alleviate burnout

• Improving patient safety is of paramount importance for any health organisation, and our findings support changes to work organisation to improve patient safety

What we are going to be doing next?

• We will keep disseminating our findings by publishing two further papers

• We are now co-developing feasible changes to shift patterns with nursing staff and their managers as part of our new project

• We have applied for further funding to maximise analysis of datasets we have created as part of this study