Characteristics of shift work and their impact on employee performance and wellbeing: A literature review
Abstract
Objectives To identify the characteristics of shift work that have an effect on employee's performance (including job performance, productivity, safety, quality of care delivered, errors, adverse events and client satisfaction) and wellbeing (including burnout, job satisfaction, absenteeism, intention to leave the job) in all sectors including healthcare.Design A scoping review of the literature was undertaken.Data sources We searched electronic databases (CINAHL, MEDLINE, PsychINFO, SCOPUS) to identify primary quantitative studies.Review methods The search was conducted between January and March 2015. Studies were drawn from all occupational sectors (i.e. health and non health), meeting the inclusion criteria: involved participants aged ≥18 who have been working shifts or serve as control group for others working shifts, exploring the association of characteristics of shift work with at least one of the selected outcomes. Reference lists from retrieved studies were checked to identify any further studies.Results 35 studies were included in the review; 25 studies were performed in the health sector. A variety of shift work characteristics are associated with compromised employee's performance and wellbeing. Findings from large multicentre studies highlight that shifts of 12h or longer are associated with jeopardised outcomes. Working more than 40h per week is associated with adverse events, while no conclusive evidence was found regarding working a 'Compressed Working Week'; working overtime was associated with decreased job performance. Working rotating shifts was associated with worse job performance outcomes, whilst fixed night shifts appeared to enable resynchronisation. However, job satisfaction of employees working fixed nights was reduced. Timely breaks had a positive impact on employee fatigue and alertness, whilst quick returns between shifts appeared to increase pathologic fatigue. The effect of shift work characteristics on outcomes in the studies reviewed is consistent across occupational sectors.Conclusions This review highlighted the complexity that encompasses shift work, but many studies do not account for this complexity. While some consistent associations emerge (e.g. 12h shifts and jeopardised outcomes), it is not always possible to conclude that results are not confounded by unmeasured factors.
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Dall'Ora et al's scoping review concluded that most studies evaluated one single characteristic and failed to take account of the many complex facets of shift work, so it was not possible to draw firm conclusions.
“Although some large scale multicentre studies showed that 12 h shifts are associated with worse staff and patient outcomes, the authors concluded that most studies evaluated one single characteristic and failed to take account of the many complex facets of shift work. It was not therefore possible to draw firm conclusions as studies were often confounded by extraneous variables [27].”
From Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures (2017) · cites this paper as [27]
Scoping reviews can be applied to better understand complex issues related to the health workforce, such as how shift work impacts employee performance across diverse occupational sectors.
“Scoping reviews can also be applied to better understand complex issues related to the health workforce, such as how shift work impacts employee performance across diverse occupational sectors, which involves a diversity of evidence types as well as attention to knowledge gaps [31].”
From Scoping reviews: reinforcing and advancing the methodology and application (2021) · cites this paper as [31]
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Self-citationScoping reviews: reinforcing and advancing the methodology and application
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“It was not therefore possible to draw firm conclusions as studies were often confounded by extraneous variables [27].”
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- Authors
- Dall’Ora, C., Ball, J., Recio-Saucedo, A., & Griffiths, P.
- Affiliations
- National Institute for Health and Care Research (GB)
- Corresponding author
- Dall’Ora, Chiara
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2016-05
- Volume
- 57
- Pages
- 12-27
- ISSN
- 0020-7489 (ISSN-L)
- OpenAlex
- W2253138815
- Cited by
- 286
- References
- 54
- Citations by year
- 2026: 38 · 2025: 25 · 2024: 28 · 2023: 30 · 2022: 45 · 2021: 30 · 2020: 39 · 2019: 22 · 2018: 13 · 2017: 16
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Nursing Studies (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Maritime Commons The Digital Repository of World Maritime University (World Maritime University) (submittedVersion)
- Funders
- National Institute for Health and Care Research (13/114/17, HS&DR/13/114/17)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- shift work, employee performance, employee well-being, burnout, job satisfaction, absenteeism, turnover intention, rotating shifts, shift length, overtime, fatigue, alertness, occupational safety, healthcare workers, adverse events, quality of care
- MeSH terms
- Burnout, Professional, Fatigue, Humans, Job Satisfaction, Personnel Turnover, Quality of Health Care, Work Schedule Tolerance, Patient Safety
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