Abstract
Objectives
To describe sleep duration and work characteristics among registered nurses (“nurses”)
across health care settings and unit types and determine the association between sleep
duration and quality of care and patient safety.
Design
We used an observational, retrospective design. Survey data were collected from two
cohorts of nurses in 2015 and 2016.
Setting
Health care and community settings across the United States, primarily acute care
hospitals.
Participants
Nurses working in a staff or general duty position (N=1,568).
Measurements
The independent variable was nurses' sleep duration before work and nonwork days.
The two dependent variables were nurse reported quality of care (single item rating)
and overall patient safety, measured by the Agency for Healthcare Research and Quality
(AHRQ) Hospital Survey on Patient Safety Culture.
Results
Nurses reported an average of 414 minutes, or just less than 7 hours, of sleep before
a work day and 497 minutes, or just over 8 hours, before a nonwork day. Short sleep
duration was statistically significantly associated with lower ratings of quality
of care (p=.002) and patient safety (p=.000).
Conclusions
Nurses are sleeping, on average, less than recommended amounts before work, which
may be impacting their health and performance on the job. Health care managers may
consider interventions to support nurses’ sleep to improve patient care. Further research
is warranted.
Keywords
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References
- About ANA.https://www.nursingworld.org/ana/about-ana/Date accessed: May 9, 2019
- Ratio of nurses to doctors, 2014 (or nearest year). Health workforce, OECD Publishing, Paris.https://doi.org/10.1787/health_glance-2015-graph60-en
- Bureau of Labor Statistics, U.S. Department of Labor Occupational Outlook Handbook. Registered Nurses.(Published 2019. Accessed May 9, 2019)
- A meta-analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes.Med Care. 2019; 57: 353-361
- Nurse Staffing and Quality of Patient Care. Vol 07-E005.Agency for Healthcare Research and Quality, Gaithersburg, MD2007
- Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction.JAMA. 2002; 288: 1987-1993
- Nurse-staffing levels and the quality of care in hospitals.N Engl J Med. 2002; 346: 1715-1722
- Educational levels of hospital nurses and surgical patient mortality.JAMA. 2003; 290: 1617-1623
- Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study.Lancet. 2014; 383https://doi.org/10.1016/S0140-6736(13)62631-8
- Changes in patient and nurse outcomes associated with magnet hospital recognition.Med Care. 2015; 53https://doi.org/10.1097/MLR.0000000000000355
- The nursing practice environment: measurement and evidence.Med Care Res Rev. 2007; 64: 104S-122S
- Nurses’ sleep quality, work environment and quality of care in the Spanish National Health System: Observational study among different shifts.BMJ Open. 2016; https://doi.org/10.1136/bmjopen-2016-012073
- The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction.Health Aff. 2012; 31: 2501-2509
- The working hours of hospital staff nurses and patient safety.Health Aff (Millwood). 2004; 23: 202-212
- The relationship between nurse work schedules, sleep duration, and drowsy driving.Sleep. 2007; 30: 1801-1807
- Sleep and errors in a group of Australian hospital nurses at work and during the commute.Appl Ergon. 2008; 39: 605-613
- Sleep, Performance, and Public Safety | Healthy Sleep.http://healthysleep.med.harvard.edu/healthy/matters/consequences/sleep-performance-and-public-safety(Published 2007. Accessed May 9, 2019)
- A pilot study of the safety implications of Australian nurses’ sleep and work hours.Chronobiol Int. 2006; 23: 1149-1163
- Associations among nurse fatigue, individual nurse factors, and aspects of the nursing practice environment.J Nurs Adm. 2018; https://doi.org/10.1097/NNA.0000000000000693
- Sleep detriments associated with quick returns in rotating shift work: A diary study.J Occup Environ Med. 2017; https://doi.org/10.1097/JOM.0000000000001006
- Sleep patterns of emergency department nurses on workdays and days off.J Nurs Res. 2016; https://doi.org/10.1097/jnr.0000000000000121
- Impact of work schedules on sleep duration of critical care nurses.Am J Crit Care. 2014; 23: 290-295
- Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses.Chronobiol Int. 2012; 29: 211-219
- Design and Methods for the Community Tracking Study.https://www.icpsr.umich.edu/icpsrweb/ICPSR/series/161Date accessed: May 28, 2019
- Mail and Internet Surveys the Tailored Design Method.John Wiley & Sons, New York2000
- RN Assessments of excellent quality of care and patient safety are associated with significantly lower odds of 30-day inpatient mortality: A national cross-sectional study of acute-care hospitals.Int J Nurs Stud. 2016; 16: 117-124
- Nurse reported quality of care: A measure of hospital quality.Res Nurs Heal. 2012; 35: 566-575
- Can staff and patient perspectives on hospital safety predict harm-free care? An analysis of staff and patient survey data and routinely collected outcomes.BMJ Qual Saf. 2015; 24: 369-376
- Organizational determinants of work outcomes and quality care ratings among Army Medical Department registered nurses.Res Nurs Health. 2010; 33: 99-110
- Magnet hospitals: Part I. Institutions of excellence.J Nurs Adm. 1988; 18: 13-24
- Find a Magnet facility.https://www.nursingworld.org/organizational-programs/magnet/find-a-magnet-facility/Date accessed: May 28, 2019
- Highlights of the National Workforce Survey of Registered Nurses.J Nurs Regul. 2013; 4: 5-13
- The National Sleep Foundation.(Published 2015. Accessed May 20, 2019)
- Relationship between sleep quality and mood in ecological momentary assessments (Preprint).JMIR Ment Heal. December 2018; https://doi.org/10.2196/12613
- Circadian disruption and human health: A bidirectional relationship.European Journal of Neuroscience. 2018;
- Metabolic and cardiovascular consequences of shift work: The role of circadian disruption and sleep disturbances.Eur J Neurosci. 2018; https://doi.org/10.1111/ejn.14216
- Shiftwork. Lyon, France.
- Fatigue, alcohol and performance impairment.Nature. 1997; 388: 235https://doi.org/10.1038/40775
- Neurobehavioral dynamics following chronic sleep restriction: dose-response effects of one night for recovery.Sleep. 2010; 33: 1013-1026
- J Sleep Res. 2003 Mar; 12: 1-12
- Nurses’ Health Study.(Published 2016. Accessed May 17, 2019)
- Harvard Work Hours Health and Safety Group.(Published 2017. Accessed May 17, 2019.)
Article info
Publication history
Published online: December 11, 2019
Accepted:
November 6,
2019
Received in revised form:
October 29,
2019
Received:
May 29,
2019
Identification
Copyright
© 2019 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
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- Erratum regarding missing declaration of competing interest statements in previously published articlesSleep Health: Journal of the National Sleep FoundationVol. 6Issue 6
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