[brian]

What they've long known about truck drivers, airplane pilots and doctors, researchers also are discovering about nurses: Those who work more than 12 straight hours make more mistakes.

Nurses who worked shifts lasting at least 12.5 hours were three times more likely to commit an error, such as giving a patient the wrong medicine or the wrong dose, than nurses who worked less than 8.5 hours, about a regular shift, according to a new study from the University of Pennsylvania School of Nursing.

Full Article: http://www.boston.com/business/artic..._nurse_errors/

[brian]

Here is another article on this topic:

Is your nurse tired and at risk of making mistakes?

Here is a not-so-surprising news flash: Nurses who work long hours and are tired make mistakes.

While the idea may seem like a no-brainer, it just got a stamp of authenticity in a national study published today in the journal Health Affairs.

This was the first study to systematically look at how work hours are related to errors, said Linda Scott, a nursing professor at Grand Valley State University. She co-wrote the study with Ann Rogers, a nursing professor at the University of Pennsylvania, and several others.

Visit: http://www.mlive.com/news/grpress/in...1753156270.xml

[brian]

Another Source:

Connection Between Nurse Fatigue, Patient Errors

...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 work periods.

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)...

http://www.newswise.com/articles/view/505905/

[NRSKarenRN]

This research is published in the journal Health Affairs:

DataWatch

The Working Hours Of Hospital Staff Nurses And Patient Safety

Ann E. Rogers, Wei-Ting Hwang, Linda D. Scott, Linda H. Aiken and David F. Dinges


The use of extended work shifts and overtime has escalated as hospitals cope with a shortage of registered nurses (RNs). Little is known, however, about the prevalence of these extended work periods and their effects on patient safety. Logbooks completed by 393 hospital staff nurses revealed that participants usually worked longer than scheduled and that approximately 40 percent of the 5,317 work shifts they logged exceeded twelve hours. The risks of making an error were significantly increased when work shifts were longer than twelve hours, when nurses worked overtime, or when they worked more than forty hours per week.

Article (subscription/one time payment):
Hospital Nurses' Working Hours
http://content.healthaffairs.org/cgi...tract/23/4/202

[ksfrn66]

Great articles, Brian, thanks! In WV we just got legislation passed to prevent mandatory overtime. It was a huge battle but the WVNA got it done this year.

Under the bill, nurses should not work more than 12 consecutive hours without an eight-hour break and none can work more than 16 hours in a 24-hour period without an eight-hour break.

Nurses cannot be forced to work overtime unless a hospital faces an unexpected emergency situation, such as a disaster, outbreak of disease or act of terrorism; or to complete a patient care procedure already under way, such as an operation.

A hospital violating the bill could be reprimanded, fined up to $500 on the second offense, and up to $5,000 on subsequent offenses.

There are only a handful of states in this nation who have passed this type of legislation.

:hatparty:

[NRSKarenRN]

PA State Nurses Association Points to Groundbreaking New Research in Support of Opposing Mandatory Overtime

Harrisburg, PA, July 8, 2004 - The PA State Nurses Association points to recently published research examining the correlation between longer shifts and increased occurrence of errors and near errors by staff nurses as proof that mandatory overtime is not conducive for delivering the highest quality of care or increasing job satisfaction and retention among nurses.

The landmark study, entitled The Working Hours of Hospital Staff Nurses And Patient Safety, aligned longer working hours for nurses to medical errors. Specifically the research concluded that the majority of staff nurses studied worked more than 40 hours in a work week, with 39% working at least 12.5 consecutive work hours and 14% working sixteen or more consecutive hours at least once during the study period. During the over 5300 examined shifts 199 errors and 213 near errors occurred, with more than half of the total errors and near errors involving medication administration.

“The study supports our efforts in limiting mandatory overtime through its findings and provides tangible evidence by concluding that working overtime increases the odds of making at least one error, regardless of how long the actual shift was scheduled,” says Michele Campbell, MSN, RNC, executive administrator for the PA State Nurses Association. “This groundbreaking study also reinforces the recent IOM recommendation in their report: Keeping Patients Safe: Transforming the Work Environment of Nurses, which states regulations, policies and practices should be designed to limit hours of direct care workers not to exceed 12 in any given 24 hour period.”

The analysis reflected that work duration, overtime and number of hours worked per week had significant effects on errors.

Read more on the report here: http://www.psna.org/c_industry.htm. This may also be accessed by going to the association's website, clicking on the Clinical Corner tab and then on Industry.

The PA State Nurses Association currently supports legislation prohibiting the use of mandatory overtime based on the premises of patient safety and nurse satisfaction. Association position statements and testimonies provided in opposition to mandatory overtime may be accessed by visiting www.panurses.org

[mattsmom81]

Good...maybe this will help stop the facilities still currently forcing mandatory overtime on its nurses. If the hospital fears litigation due to THEIR role in demanding the long hours, they may think twice.

[jemb]

I love it that this problem is finally getting some media attention!

Where I work, many of our patients and families express concern about the nurses working "too hard and too long", as they put it. I think it is sad that not only does overwork affect the care the patient receives, but that the patients and families are seeing it!