What Is the Impact of the 12-hour Shift on Nursing Staff Working in Adult Wards?: A Systematised Literature Review

Abstract

Background: Originally, 24-hour nursing care was defined by a standard three eight-hour shifts. However, over the last three decades, the 12-hour shift has been introduced internationally, although there is growing evidence of its potential impact on nursing staff in adult wards, despite its financial and organisational benefits. Aim: To investigate the potential impact of 12-hour shift patterns on nurses working in adult wards. Methods: A systematised literature review was undertaken to inform the review question, which was formulated using a population, exposure, and outcomes (PEO) framework. EMBASE, PsycINFO, CHINHAL and MEDLINE were subsequently searched for the period 2017- 2020. Primary studies in English were included, measuring the outcomes of nurses working 12-hour shifts on adult hospital wards. Suitable studies were selected using online Covidence software, and assessed for quality with CASP and JBI tools. Noticeable heterogeneity across the searched literature led to narrative synthesis in this review. Results: All 10 studies included were quantitative and met the inclusion criteria: nine observational (four prospective longitudinal, two retrospective cohort, and three cross- sectional), and one quasi-experimental study. The themes of health and wellbeing, job performance, professional development and job satisfaction were identified. However, overall methodological quality was low to moderate, with instances of bias in selection and sampling. Conclusions: Little evidence of either positive or negative effects of 12-hour shifts was found among nursing staff in adult wards. However, a likely association is suggested between 12- hour shifts, high levels of fatigue, poor sleep quality, and reduced sickness absence. Consequently, further high-quality experimental and qualitative research studies are required in this area