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National recommendations for shift scheduling in healthcare: A 5-year prospective cohort study on working hour characteristics
International Journal of Nursing Studies ( IF 8.1 ) Pub Date : 2022-07-03 , DOI: 10.1016/j.ijnurstu.2022.104321
Mikko Härmä 1 , Rahman Shiri 1 , Jenni Ervasti 1 , Kati Karhula 1 , Jarno Turunen 1 , Aki Koskinen 1 , Annina Ropponen 2 , Mikael Sallinen 1
Affiliation  

Background

National recommendations to decrease the health and safety risks of working hours are often given based on the increasing knowledge of the associations between working hour characteristics and health. However, the utilization of the recommendations, and their potential to change the actual working time patterns in healthcare sector is unclear.

Objective

We investigated the extent to which the national recommendations are utilized in shift scheduling, when they are integrated as a shift schedule evaluation tool into the shift scheduling software. Second, we examined whether the use of the tool results in changes that are in line with the recommendations.

Design

A prospective cohort study with a 5-year follow-up.

Participants

A total of 36,663 healthcare workers with objective data on daily working hours in 10 hospital districts and 6 large cities.

Methods

We investigated the annual use of the evaluation tool, and the effects of using the tool on annual changes in working hour characteristics from 2015 to 2019 while adjusting for the hierarchical structure of the data, age, sex, shift work, night work, work contract days and the type of shift scheduling software. Utilizing intention-to-treat principle, the employees in wards using the tool were compared to non-users by multi-level generalized linear models.

Results

Continuous use (during at least 10 scheduling periods) of the evaluation tool increased from 2% in 2015 to 20% in 2018. In the fully adjusted model, the use of the evaluation tool was associated with the decrease of > 6 consecutive workdays (OR 0.73, 95% CI 0.66, 0.81), > 4 consecutive night shifts (OR 0.86, 95% CI 0.77, 0.95), and proportion of < 11-hour shift intervals (difference 0.63, 95% CI 0.43, 0.83). The proportion of single days off (difference 0.33, 95% CI 0.15, 0.51), and > 40-hour work weeks (OR 1.16, 95% CI 1.10, 1.22), as well as the proportion of ≥ 12-hour work shifts (OR 1.22, 95% CI 1.07, 1.38) increased. Realized shift wishes decreased (difference 0.76, 95% CI 0.12, 1.41). The use of the tool was associated with more frequent changes towards the recommendations in the cities compared to the hospital districts, and among the older age groups compared to the ≤ 30-year-old employees.

Conclusions

National recommendations embedded in the shift schedule evaluation tool were used continuously by one fifth of the employees, and were associated with several, albeit modest changes towards the given recommendations. Changes in working hour characteristics depended on organization indicating for differences in the implementation of the recommendations.

Tweetable abstract

The national recommendations for safer working hour characteristics embedded in a shift schedule evaluation tool are associated with several, albeit modest changes in working hour characteristics.



中文翻译:

医疗保健轮班安排的国家建议:关于工作时间特征的 5 年前瞻性队列研究

背景

减少工作时间的健康和安全风险的国家建议通常是基于对工作时间特征与健康之间关系的认识不断增加。然而,这些建议的使用以及它们改变医疗保健部门实际工作时间模式的潜力尚不清楚。

客观的

我们调查了国家建议在班次安排中的应用程度,当它们作为班次安排评估工具集成到班次安排软件中时。其次,我们检查了该工具的使用是否会导致符合建议的更改。

设计

一项为期 5 年的前瞻性队列研究。

参与者

共有 36,663 名医护人员在 10 个医院区和 6 个大城市提供每日工作时间的客观数据。

方法

我们调查了评估工具的年度使用情况,以及使用该工具对 2015 年至 2019 年工作时间特征年度变化的影响,同时调整了数据的层次结构、年龄、性别、轮班工作、夜间工作、工作合同天数和排班软件的类型。利用意向治疗原则,通过多级广义线性模型将使用该工具的病房员工与非用户进行比较。

结果

评估工具的持续使用(在至少 10 个调度周期内)从 2015 年的 2% 增加到 2018 年的 20%。在完全调整的模型中,评估工具的使用与 连续 6 个工作日以上(或0.73, 95% CI 0.66, 0.81),>  4 个连续夜班(OR 0.86, 95% CI 0.77, 0.95),以及<  11 小时轮班间隔的比例(差异 0.63, 95% CI 0.43, 0.83)。单日休假的比例(差异 0.33, 95% CI 0.15, 0.51)和>  40小时工作周(OR 1.16, 95% CI 1.10, 1.22),以及≥的比例 12 小时轮班制 (OR 1.22, 95% CI 1.07, 1.38) 增加。实现的换班愿望减少(差异 0.76, 95% CI 0.12, 1.41)。 与医院区相比,该工具的使用与城市中对建议的更频繁变化有关,并且与≤30岁的员工相比,在年龄较大的群体中。

结论

五分之一的员工持续使用轮班计划评估工具中嵌入的国家建议,并与一些相关的建议,尽管对给定建议的变化不大。工作时间特征的变化取决于组织表明实施建议的差异。

可推文摘要

轮班时间表评估工具中嵌入的关于更安全工作时间特征的国家建议与工作时间特征的一些变化有关,尽管变化不大。

更新日期:2022-07-03
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