Changing from 12 hour to 8 hour day shifts: a qualitative exploration of effects on organising nursing care and staffing

Aims and objectives: To investigate 1) How nursing care is organised on wards where nursing staff work different lengths of day shifts, and 2) How length of day shift affects the staffing of wards. Background: Twelve hour shifts have become increasingly common worldwide but there are concerns about impact on care quality and safety. Eight hour shifts, and how day shift length affects how nurses organise their work, and staffing, have been little studied. Design: Case study Methods: The setting was two older people’s wards in an acute hospital in England. Nursing staff on one ward continued to work 12 hour day shifts; staff on the other ward worked 8 hour late and early day shifts, with an afternoon overlap, for 6 months. Qualitative interviews were conducted with 22 nursing staff. Semi-structured observations were conducted from 12-15.00 (5 X 3 hour episodes on each ward). Data analysis was conducted using the Framework approach. Results: Theme 1: Organising nursing care and staff activities, (sub-themes: Care delivery across a 12 hour shift; Care delivery on early and late 8 hour shifts; Staff communication and documentation; Staff breaks; Teaching, supervision and staff development); Theme 2: Staffing wards with different length of day shift (sub-themes:: Adequacy of staffing and use of temporary staff; Recruitment and retention of staff after introducing 8 hour shifts). Conclusion: Nursing staff organised care on 8 hour shifts similarly to 12 hour shifts but then felt dissatisfied with their care delivery and handovers. Nursing staff on both wards approached care in a task-focused way. There were concerns that adopting an 8 hour shift pattern negatively affected recruitment and retention. This is the peer reviewed version of the following article: Baillie, L. and Thomas, N. (2018), Changing from 12 hour to 8 hour day shifts: a qualitative exploration of effects on organising nursing care and staffing. J Clin Nurs. doi:10.1111/jocn.14674, which will be published in final form at https://onlinelibrary.wiley.com/journal/13652702. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.