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Nurses' extended work hours: Patient, nurse and organizational outcomes
Author(s) -
Kunaviktikul W.,
Wichaikhum O.,
Nantsupawat A.,
Nantsupawat R.,
Chontawan R.,
Klunklin A.,
Roongruangsri S.,
Nantachaipan P.,
Supamanee T.,
Chitpakdee B.,
Akkadechanunt T.,
Sirakamon S.
Publication year - 2015
Publication title -
international nursing review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.84
H-Index - 51
eISSN - 1466-7657
pISSN - 0020-8132
DOI - 10.1111/inr.12195
Subject(s) - workload , medicine , nursing , depersonalization , job satisfaction , logistic regression , descriptive statistics , emotional exhaustion , psychology , burnout , clinical psychology , social psychology , statistics , mathematics , computer science , operating system
Background Nursing shortages have been associated with increased nurse workloads that may result in work errors, thus impacting patient, nurse and organizational outcomes. Aim To examine for the first time in T hailand nurses' extended work hours (working more than 40 h per week) and its relationship to patient, nurse and organizational outcomes. Methods Using multistage sampling, 1524 registered nurses working in 90 hospitals across T hailand completed demographic forms: the N urses' E xtended W ork H ours F orm; the P atient, N urse, O rganizational O utcomes F orm; the O rganizational P roductivity Q uestionnaire and the M aslach B urnout I nventory. The data were analysed using descriptive statistics, S pearman's rank correlation and logistic regression. Results The average extended work hour of respondents was 18.82 h per week. About 80% worked two consecutive shifts. The extended work hours had a positive correlation with patient outcomes, such as patient identification errors, pressure ulcers, communication errors and patient complaints and with nurse outcomes of emotional exhaustion and depersonalization. Furthermore, we found a negative correlation between extended work hours and job satisfaction as a whole, intent to stay and organizational productivity. Nurses who had extended work hours of >16 h per week were significantly more likely to perceive all four adverse patient outcomes than participants working an extended ≤8 h per week. Limitations Patient outcomes were measured by respondents' self‐reports. This may not always reflect the real occurrence of adverse events. Conclusions Associations between extended work hours and outcomes for patients, nurses and the organization were found. The findings demonstrate that working two shifts (16 h) more than the regular work hours lead to negative outcomes for patients, nurses and the organization.Implications for nursing and health policy Our findings add to increasing international evidence that nurses' poor working conditions result in negative outcomes for professionals, patients and health systems. Policymakers need to be aware of the issues regarding nurses' extended work hours, which has been found to contribute to burnout. Urgently, nurse and health administrators need to develop and implement appropriate nursing overtime policies and strategies to help reduce this phenomenon, including measures to overcome the nursing shortage.