Nurses' moves towards 12-hour shifts could carry patient safety risks

The increasing move for nurses to work 12-hour shifts could pose significant risks to patient safety, according to research.

Research published today by NHS England shows an increase in the use of 12-hour shifts among nurses in the UK, which may have a knock-on effect on patient care.

The research was undertaken by King’s College London’s National Nursing Research Unit (NNRU), the University of Southampton and the international nursing research consortium RN4Cast.

Researchers reviewed 26 studies that were carried out between 1982 and 2014 in the UK, USA and EU, which focused on the prevalence and impact of 12-hour shifts in nursing.  

Employment surveys conducted for the RCN and the findings of a survey of nurses at English hospitals conducted as part of last year’s RN4Cast study were also examined.

The independent report, ‘12-hour shifts: prevalence views and impact’ was commissioned by England’s chief nursing officer Jane Cummings to look at links between nursing shift length and patient outcomes.

Welcoming the research, Ms Cummings said: ‘It is really important that we continue to develop a body of research to inform safe staffing to support senior local professional judgements.’

The study, led by University of Southampton principal research fellow Jane Ball, found that 12-hour shifts have become more prevalent in the NHS. In 2009, more than half of nurses (52%) on NHS wards reported working 12-hour shifts, compared with 31% in 2005.   

Ms Ball said: ‘This new analysis of data from England, found that working 12-hour or longer shifts is associated with care being rated as ‘poor quality’ and an increased risk that necessary nursing care is left undone. It seems clear that there are risks associated with a move to longer shifts and they need to be managed very carefully.’

NNRU director and professor of nursing research, Jill Maben, said: ‘Our work shows that in spite of limited evidence, 12-hour shifts have increased across the NHS without fully understanding the risks to patient safety and staff well-being.

'While many nurses value the flexibility that working fewer long shifts offer, the study highlights the risks of long hours in terms of performance, fatigue, stress and patient safety.'

University of Southampton chair of health services research, Peter Griffiths, said: ‘These findings mirror those of our European-wide study, which shows that longer shifts are associated with nurses reporting lower quality care, more missed care and higher levels of nurse burnout. Meanwhile, the overall job satisfaction reported is no better for those working 12-hour shifts than those working 8-hour shifts.’

Read the report here.