Nursing Overtime and Patient Safety

3337 words 14 pages
Nursing Overtime and Adverse Effects
Blima Marcus
Hunter College

Abstract
This paper will explore the topic of nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace
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The Research
Research by Ols and Clarke (2010) showed that nurses who worked more than 40 hours per week were 28% more likely to make a medication error, and for every additional hour of overtime each week, that risk increased by 2%. According to Rogers, Hwang, Scott, Aiken & Dinges (2004), nurses who work more than 12.5 consecutive hours have three times the risk of making an error, as compared to nurses who work fewer hours. In a subsequent study, Rogers collected data from 502 critical care nurses to study the impact of long work hours on vigilance. Long shifts were again defined as more than 12.5 consecutive hours, or more than 40 hours per workweek. Nearly 65% of the nurses reported difficulty staying awake during their shifts and 20% said they fell asleep at least once during their work shift (Scott, Rogers, Hwang & Zhang, 2006).
An observational study that examined elderly patients in intensive care units at 31 hospitals found a significant association between nurse staffing and rates of central line associated bacteremia (CLABS), ventilator acquired pneumonia (VAP), 30-day mortality and decubiti (Stone et al., 2007). Less overtime was associated with a lower incidence of CLABS.
Further research in 2011 by Weiss, Yakusheva and Bobay studied the relationship between nurse staffing and postdischarge outcomes. Nurse staffing over 7 months was tracked, along with Emergency

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