Virya Koy1, Jintana Yunibhand2, Sue Turale3. 1. Department of Hospital Services, and Chief Nursing Officer/Nursing Focal Person in Cambodia for WHO-WPRO. 2. Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand. 3. Chiang Mai University, Faculty of Nursing Chiang Mai, Thailand.
Abstract
AIM: To explore the perceptions and experiences of Cambodian ICU registered nurses regarding their working 24-hour shifts. BACKGROUND: In Europe and the USA nurses are moving to a 12-hour shift, and numerous studies have revealed the positive and negative effects of these. However, lesser known is the impact of 24-hour nursing shifts on care quality, and health and safety. In Cambodia, 100% of nurses are rostered for these in their shift patterns, but until this study no research had been conducted on such shifts. DESIGN: A qualitative descriptive study. METHOD: Three focus group discussions were conducted with 30 registered nurses in July 2019, ten in each group, from three intensive care units of three hospitals in Cambodia. Data saturation was obtained. Data were analyzed using content analysis, and the COREQ was applied for reporting this study. FINDINGS: The ICU nurses' perspectives revealed significant and unacceptable effects of working shifts of ~25-hour length, taking into account staff handover. Two major themes arose: It is so exhausting and Compromised hospital care. Alarmingly, participants worked on average 72 hours per week, were exhausted, and nursed between 6-10 critically ill patients per shift. CONCLUSION: To our knowledge this is the first study on nurses working 24-hour shifts, revealing unacceptable, high risks for the health and safety of nurses and patients, with nursing activities left undone, and a lack of quality care. RELEVANCE TO CLINICAL PRACTICE: Improving nurse and patient health and safety, and quality of care requires hospital leaders to work with government and nursing organizations to develop better shift strategies. Resources need to be provided so that: nurses can work a maximum 12-hour shifts; the ratio of nurses to patients is improved; and nurses can have decent break times. This has major implications, for not only practice, but also management, administration, budgets and education. This article is protected by copyright. All rights reserved.
AIM: To explore the perceptions and experiences of Cambodian ICU registered nurses regarding their working 24-hour shifts. BACKGROUND: In Europe and the USA nurses are moving to a 12-hour shift, and numerous studies have revealed the positive and negative effects of these. However, lesser known is the impact of 24-hour nursing shifts on care quality, and health and safety. In Cambodia, 100% of nurses are rostered for these in their shift patterns, but until this study no research had been conducted on such shifts. DESIGN: A qualitative descriptive study. METHOD: Three focus group discussions were conducted with 30 registered nurses in July 2019, ten in each group, from three intensive care units of three hospitals in Cambodia. Data saturation was obtained. Data were analyzed using content analysis, and the COREQ was applied for reporting this study. FINDINGS: The ICU nurses' perspectives revealed significant and unacceptable effects of working shifts of ~25-hour length, taking into account staff handover. Two major themes arose: It is so exhausting and Compromised hospital care. Alarmingly, participants worked on average 72 hours per week, were exhausted, and nursed between 6-10 critically illpatients per shift. CONCLUSION: To our knowledge this is the first study on nurses working 24-hour shifts, revealing unacceptable, high risks for the health and safety of nurses and patients, with nursing activities left undone, and a lack of quality care. RELEVANCE TO CLINICAL PRACTICE: Improving nurse and patient health and safety, and quality of care requires hospital leaders to work with government and nursing organizations to develop better shift strategies. Resources need to be provided so that: nurses can work a maximum 12-hour shifts; the ratio of nurses to patients is improved; and nurses can have decent break times. This has major implications, for not only practice, but also management, administration, budgets and education. This article is protected by copyright. All rights reserved.
Entities:
Keywords:
Intensive care; Nursing care quality; Qualitative study; Registered nurses; Shift work
Authors: Holly Blake; Alisha Gupta; Mahnoor Javed; Ben Wood; Steph Knowles; Emma Coyne; Joanne Cooper Journal: Int J Environ Res Public Health Date: 2021-03-31 Impact factor: 3.390