BACKGROUND Twenty-four hour nursing care involves shift work including 12-h shifts. England is unusual in deploying a mix of shift patterns. International evidence on the effects of such shifts is growing. A secondary analysis of data collected in England exploring outcomes with 12-h shifts examined the association between shift length, job satisfaction, scheduling flexibility, care quality, patient safety, and care left undone. METHODS Data were collected from a questionnaire survey of nurses in a sample of English hospitals, conducted as part of the RN4CAST study, an EU 7th Framework funded study. The sample comprised 31 NHS acute hospital Trusts from 401 wards, in 46 acute hospital sites. Descriptive analysis included frequencies, percentages and mean scores by shift length, working beyond contracted hours and day or night shift. Multi-level regression models established statistical associations between shift length and nurse self-reported measures. RESULTS Seventy-four percent (1898) of nurses worked a day shift and 26% (670) a night shift. Most Trusts had a mixture of shifts lengths. Self-reported quality of care was higher amongst nurses working ≤8 h (15.9%) compared to those working longer hours (20.0 to 21.1%). The odds of poor quality care were 1.64 times higher for nurses working ≥12 h (OR = 1.64, 95% CI 1.18-2.28, p = 0.003). Mean 'care left undone' scores varied by shift length: 3.85 (≤8 h), 3.72 (8.01-10.00 h), 3.80 (10.01-11.99 h) and were highest amongst those working ≥12 h (4.23) (p < 0.001). The rate of care left undone was 1.13 times higher for nurses working ≥12 h (RR = 1.13, 95% CI 1.06-1.20, p < 0.001). Job dissatisfaction was higher the longer the shift length: 42.9% (≥12 h (OR = 1.51, 95% CI 1.17-1.95, p = .001); 35.1% (≤8 h) 45.0% (8.01-10.00 h), 39.5% (10.01-11.99 h). CONCLUSIONS Our findings add to the growing international body of evidence reporting that ≥12 shifts are associated with poor ratings of quality of care and higher rates of care left undone. Future research should focus on how 12-h shifts can be optimised to minimise potential risks.

中文翻译：

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横断面检查轮班时间与医院护士工作满意度和护士报告的质量指标之间的关系。

背景技术二十四小时护理包括轮班工作，包括12小时轮班。英格兰在混合使用各种轮班模式方面很不寻常。关于这种转变的影响的国际证据正在增长。对英格兰收集的数据进行的第二次分析探讨了12小时轮班的结果，检查了轮班时间，工作满意度，日程安排灵活性，护理质量，患者安全和未得到护理之间的关联。方法数据是从RN4CAST研究（欧盟第七框架资助的研究）的一部分中对英国一家医院样本中的护士进行的问卷调查收集的。样本包括来自46个急性医院站点的401个病房的31个NHS急性医院信托基金。描述性分析包括按班次长短进行的频率，百分比和平均得分，超出合同规定的小时数和日夜班制。多级回归模型建立了班次长度与护士自我报告的测量之间的统计关联。结果百分之七十四（1898）的护士白天上班，百分之26（670）夜班。大多数信托的轮班时间长短不一。在工作时间≤8小时的护士中，自我报告的护理质量更高（15.9％），而工作时间更长的护士（20.0至21.1％）则更高。对于工作时间≥12小时的护士，低质量护理的几率要高1.64倍（OR = 1.64，95％CI 1.18-2.28，p = 0.003）。平均'照看不做'评分因班次而异：3.85（≤8h），3.72（8.01-10.00 h），3.80（10.01-11.99 h），在工作≥12 h（4.23）的人群中最高（p <0.001 ）。工作≥12小时的护士放弃护理的比例要高1.13倍（RR = 1.13，95％CI 1.06-1.20，p <0.001）。