The quality of nursing care on wards working eight and twelve hour shifts: a repeated measures study using the MONITOR index of quality of care.

Interest in 12 hr nursing shifts has renewed in response to demands for improved cost effectiveness in the NHS, but the effects of this shift on patient care are unclear. A repeated measures study of 10 wards comparing quality of care, measured by MONITOR, under 8 and 12 hr shifts was conducted. The overall MONITOR scores were significantly lower under the 12 hr shift, with planning, non-physical care and evaluation of care scales showing significant decreases. The pattern of results when data were analysed by patient dependency levels reveals that whilst the quality of care overall for the four dependency categories was significantly poorer under the 12 hr shift, the lower dependency categories were less adversely affected in terms of physical and non-physical care delivered.