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

Chiara Dall’Ora,Antonello Maruotti,Peter Griffiths,Jane Ball,Oliver Redfern,Alejandra Recio-Saucedo,Paul Meredith

doi:10.1111/jonm.12643

Abstract

ObjectiveTo investigate whether working 12 hr shifts is associated with increased sickness absence among registered nurses and health care assistants.BackgroundPrevious studies reported negative impacts on nurses’ 12 hr shifts; however, these studies used cross‐sectional techniques and subjective nurse‐reported data.MethodsA retrospective longitudinal study using routinely collected data across 32 general inpatient wards at an acute hospital in England. We used generalized linear mixed models to explore the association between shift patterns and the subsequent occurrence of short (<7 days) or long‐term (≥7 days) sickness absence.ResultsWe analysed 601,282 shifts and 8,090 distinct episodes of sickness absence. When more than 75% of shifts worked in the past 7 days were 12 hr in length, the odds of both a short‐term (adjusted odds ratio = 1.28; 95% confidence index: 1.18–1.39) and long‐term sickness episode (adjusted odds ratio = 1.22; 95% confidence index: 1.08–1.37) were increased compared with working none.ConclusionWorking long shifts on hospital wards is associated with a higher risk of sickness absence for registered nurses and health care assistants.Implications for Nursing ManagementThe higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals. The routine implementation of long shifts should be avoided.

Highlights

Reducing sickness absence is high on health care employers’ agenda, in the context of staff shortages and the adverse effect on over‐ all productivity and costs (Johnson, Croghan, & Crawford, 2003; Letvak & Buck, 2008; NHS Employers, 2014)
Within England’s NHS hospitals, the nursing workforce is composed of registered nurses (RN) and variously titled health care assistants or health care support workers (HCA) who provide “hands on” care
For long‐term sickness absence, the only significant association was found for staff working >75% of their past shifts as ≥12 hr or more, compared with those working no 12 hr or more shifts at all (AOR = 1.22, 95% CI: 1.08–1.39), all other proportions of long shifts were associated with non‐signif‐ icant increases (Table 5)

Summary

Introduction

Reducing sickness absence is high on health care employers’ agenda, in the context of staff shortages and the adverse effect on over‐ all productivity and costs (Johnson, Croghan, & Crawford, 2003; Letvak & Buck, 2008; NHS Employers, 2014). High rates of absenteeism among health care staff have been associated with lower patient satisfaction (Duclay, Hardouin, Sebille, Anthoine, & Moret, 2015) | 20 DALL’ORA et al. Workplace factors have been shown to play a significant role in increasing sickness absence (Hahtela et al, 2015; National Institute for Health & Care Excellence, 2008). Workplace factors have been shown to play a significant role in increasing sickness absence (Hahtela et al, 2015; National Institute for Health & Care Excellence, 2008) Among these factors, aspects of shift work, such as long shifts have been associated with de‐ creases in employees’ well‐being and increases in sickness absence (Fekedulegn et al, 2013; Michie & Williams, 2003). A systematic re‐ view found limited evidence for the effect of aspects of shift work on sickness absence, concluding that evening work was associated with higher sickness absence levels (Merkus et al, 2012)

Methods

Findings

Discussion

Conclusion