Bold Voices - July 2011 - (Page 15)
AT THE BEDSIDE
Long Hours, Lack of Time Off Can Affect Patient Outcomes
study in January/February’s Nursing Research associates nurses’ work schedules with patient mortality, suggesting their schedules have an independent effect on patient outcomes. “Nurses’ Work Schedule Characteristics, Nurse Stafﬁ ng, and Patient Mortality” ﬁ nds a 42 percent rise in pneumonia-related deaths in hospitals where nurses work long hours. Lack of time away from work correlates to a 24 percent rise in these deaths and a 39 percent increase in abdominal aortic aneurysms among patients, it notes. Working while sick increased rates for patient congestive heart failure by 39 percent. Nurses’ “weekly burden” led to a 33 percent increase in patient incidence of acute myocardial infarction. “Attention to work schedule is now warranted on the basis of the impact of scheduling on patients as well as nurses.” To reduce sleep deprivation among nurses, the study advises “alternatives to 12-hour shifts” and “completely relieved breaks” during the workday. A related Nurse.com article notes that the study compared survey responses from 633 randomly selected nurses at 71 acute care hospitals in Illinois and North Carolina. “With the latest study linking patient deaths from pneumonia and acute myocardial infarction to longer shifts, the authors hope to call new attention to the issue,” it notes. The article quotes study co-author Alison Trinkoff, professor, Maryland School of Nursing, Baltimore, on sleep-deprived, overworked clinicians. She says, “Nurses need time off to rest and recuperate for their own health and to ensure a high level of performance on the job.” How do you ensure completely relieved breaks in your hospital? Write to us at aacnboldvoices@ aacn.org, or use the blue auto-reply bubble on this page of the digital edition.
The Standard Says ‘Appropriate Stafﬁng’
“Nurse Stafﬁng and Inpatient Hospital Mortality” in the March 17 New England Journal of Medicine associates stafﬁng of RNs below target levels with increased mortality, reinforcing the need to match stafﬁng with patients’ needs. Appropriate stafﬁng, one of AACN’s Standards for Establishing and Sustaining Healthy Work Environments, seeks to counteract potential adverse effects on patient outcomes caused by nurse schedules. The standard requires stafﬁng that ensures “the effective match between patient needs and nurse competencies.” Learn more about the standards at www.aacn.org/hwe, and assess the health of your work environment using the free online tool at www.hweteamtool.org.
Completely relieved breaks and alternatives to 12-hour shifts reduce sleep deprivation.
AACN BOLD VOICES JULY 2011 15
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