Table 3

Evidenced-Based Practice Recommendations Related to Shift Duration and Number of Workhours During a Week

RecommendationPractice Implication
Schedules that involve working 48 or 60 hours per week,193 or working 7 consecutive 12-hour shifts in one week in order to have 7 consecutive days off the next week194 are unacceptably risky,83 and should be prohibited.Do not work any more than 48 hours in a 7-day period.
The continued use of 12-hour shifts cannot be recommended given the current working conditions, including the almost daily need for nurses to stay beyond the end of their scheduled shift, the frequent absence of breaks during the workday, and the higher risk of errors associated with 12-hour shifts.14, 69, 126Nurse managers should not schedule nurses for 12-hour shifts and nurses should not request 12-hours shifts.
If nurses insist on continuing to work 12-hour shifts, several measures should be taken to reduce the risks to patients and nurses. These steps include reducing the number of consecutive shifts to no more than three,83, 104 providing adequate meal and rest breaks,120, 195 revising schedules to ensure that nurses have at least 10–12 hours off between work shifts so that they have adequate time for sleep, commuting, and completing their domestic responsibilities, and requiring that nurses use their off-duty time to get sufficient sleep.If you are scheduled to work a 12-hour shift, (1) do not work more than three shifts without a day off; (2) insist that provisions are made for sufficient staffing to ensure that you are able to be free of patient care responsibilities for 10 minutes every 2 hours and for 30 minutes to eat a meal; and (3) insist that you have at least 10–12 hours off between shifts so that you can obtain sufficient sleep.

From: Chapter 40, The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety

Cover of Patient Safety and Quality
Patient Safety and Quality: An Evidence-Based Handbook for Nurses.
Hughes RG, editor.

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