Nurses' work schedule characteristics, nurse staffing, and patient mortality

Alison M. Trinkoff, Meg Johantgen, Carla L. Storr, Ayse Gurses, Yulan Liang, Kihye Han

Research output: Contribution to journalArticle

Abstract

Background: Although nurse staffing has been found to be related to patient mortality, there has been limited study of the independent effect of work schedules on patient care outcomes. Objective: To determine if, in hospitals where nurses report more adverse work schedules, there would be increased patient mortality, controlling for staffing. Methods: A cross-sectional design was used, with multilevel data from a 2004 survey of 633 nurses working in 71 acute nonfederal hospitals in North Carolina and Illinois. Mortality measures were the risk-adjusted Agency for Healthcare Research and Quality Inpatient Quality Indicators, and staffing data were from the American Hospital Association Annual Survey of hospitals. Principal components analysis was conducted on the 12 work schedule items to create eight independent components. Generalized estimating equations were used to examine the study hypothesis. Results: Work schedule was related significantly to mortality when staffing levels and hospital characteristics were controlled. Pneumonia deaths were significantly more likely in hospitals where nurses reported schedules with long work hours (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.17-1.73, p <.01) and lack of time away from work (OR = 1.24, 95% CI = 1.03-1.50, p <.05). Abdominal aortic aneurysm was also associated significantly with the lack of time away (OR = 1.39, 95% CI = 1.11-1.73, p <.01). For patients with congestive heart failure, mortality was associated with working while sick (OR = 1.39, 95% CI = 1.13-1.72, p <.01), whereas acute myocardial infarction was associated significantly with weekly burden (hours per week; days in a row) for nurses (OR = 1.33, 95% CI = 1.09-1.63, p <.01). Discussion: In addition to staffing, nurses' work schedules are associated with patient mortality. This suggests that work schedule has an independent effect on patient outcomes.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalNursing Research
Volume60
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Appointments and Schedules
Nurses
Mortality
Odds Ratio
Confidence Intervals
American Hospital Association
Health Services Research
Abdominal Aortic Aneurysm
Principal Component Analysis
Inpatients
Pneumonia
Patient Care
Heart Failure
Myocardial Infarction

Keywords

  • mortality
  • patient outcomes
  • work schedule
  • working conditions

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Nurses' work schedule characteristics, nurse staffing, and patient mortality. / Trinkoff, Alison M.; Johantgen, Meg; Storr, Carla L.; Gurses, Ayse; Liang, Yulan; Han, Kihye.

In: Nursing Research, Vol. 60, No. 1, 01.2011, p. 1-8.

Research output: Contribution to journalArticle

Trinkoff, Alison M. ; Johantgen, Meg ; Storr, Carla L. ; Gurses, Ayse ; Liang, Yulan ; Han, Kihye. / Nurses' work schedule characteristics, nurse staffing, and patient mortality. In: Nursing Research. 2011 ; Vol. 60, No. 1. pp. 1-8.
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