Comparison of 12 and 24-hours shift impacts on ICU nursing care, efficiency, safety, and work-life quality

Abstract

Background: Nursing care quality is a central concern of health policy, and nurses’ shift schedules affect the quality of care and their work-life status internationally. A lack of reliable information on the differences between 24- and 12-h shifts on care quality, nursing care quality, patient safety, and adverse and missed events warranted investigation in Cambodia. Aim: We aimed to examine the impacts of 12-h shifts compared with 24-h shifts. The purpose was to find evidence to support the use of maximum 12-h shifts by registered nurses working in ICU contexts. Method: A convergent mixed-method approach was chosen to highlight the issues around the long hours of shift work. We designed a 12-week coaching course during the implementation of 12-h shifts and assigned 30 nurses each to an experimental group and a control group. Data from quantitative surveying of 58 participants were combined with focus group discussions of 20 participants to gather qualitative insights. Pre- and post-test analysis involved descriptive statistics and the Wilcoxon sign rank test for quantitative analysis and then merged with qualitative findings from content analysis. Reporting of this study was steered by the STROBE and COREQ guidelines for quantitative and qualitative findings, respectively. Results: Quantitative results showed the increased quality of nursing work-life, nursing care quality, and patient satisfaction; decreased missed care and adverse events were significantly associated with the 12-h shift. Qualitative data supported nurses preferring 12-h rather than 24-h shift options. Discussion and conclusions: Changing rosters to 12-h shifts in the intervention caused increases in the study variables’ scores. Results indicate the benefits of 12-h shifts on the quality of nursing work-life, nursing care quality, missed care, adverse events, and patient safety. Implications for nursing and nursing policy: We found that 24-h shifts had deleterious impacts on care quality and safety and nurse satisfaction with work. Health and nursing policymakers are urged to provide resources and strategize to implement 12 h shifts as soon as possible since the current 24-h shifts of nurses affect the patient quality of care and their health and safety and that of the nurses.