Is The Effect Of Nurses Shift Length And Overtime Working On Quality Of Care And Patient Safety

1609 Words 7 Pages
Introduction. The purpose of this paper is to critically appraise a research article on the topic of the effect of nurses’ shift length and overtime working on quality of care and patient safety. The article is titled, “Nurses’ Shift Length and Overtime Working in 12 European Countries. The Association with Perceived Quality of Care and Patient Safety.” The authors are Peter Griffith, Chiara Dall’Ora, Michael Simon, Jane Ball, Rikard Lindqvist, Anne-Marie Rafferty, Lisette Schoonhoven, Carol Tishelman, and Linda H. Aiken. The article was published in November 2014 by Lippincott Williams & Wilkins. Abstract. The abstract was thorough and concise. It included key elements such as the study problem, objectives, methods, results, and …show more content…
The major variables were identified under measurements. The independent variables were the shift lengths and whether the nurses had worked overtime. Griffith et al. grouped shift lengths into 5 categories: ≤8, 8.1–10, 10.1–11.9, 12–13, >13 hours. The researchers did not explain how these categories were formed; a reason to this could give an insight on how each category would be significant in the analysis. The dependent variables were quality of care, patient safety, and whether care was left undone. Quality of care is associated to hospital level mortality, patient satisfaction, and care processes and a “poor” and “fair” response to these items reflected a negative evaluation of quality. Although patient safety was not conceptually defined, it was measured by responses as poor, failing, acceptable, very good, or excellent. A “poor” and “failing” rating was an indication of a negative evaluation of patient safety. Defining patient safety would have provided clarity to the variable being measured. The third dependent variable is care left undone during the nurses’ last shift. This variable was measured by summing 13 common nursing activities left undone, resulting in a score of a number zero to 13. The researchers failed to explain these activities, in which would have strengthened the validity of the variable being measured. Griffith et al. did not mention potential confounding variables, but they noted control variables such as shift type, ward type, …show more content…
Griffith et al. provided clear information on the tools used to measure the variables in the study, yet they fail to include the reliability and validity of most tools. The survey was based on the International Hospital Outcomes Study questionnaire and the content validity index for all items used in the survey were classified as good or better with content validity index >0.6. Responses of the quality of care and patient safety were grouped to reflect negative or positive evaluations. A “poor and fair” response reflected a negative evaluation on quality of care, and a “poor” and “failing,” reflected a negative evaluation on patient safety. The reliability and validity for these measurements were not mentioned. Common activities were derived from the BERNCA instrument to measure nursing duties that were left undone, however the reliability and validity of the instrument were also unexplained. A reported shift length that was ≥18 hours was excluded because it was 8 hours increased the odds of adverse quality and safety. Significant findings were explained, however non-significant findings were not explained. This made the interpretation of the data difficult because it did not explain whether this might have been attributed to a small sample

Related Documents