The effect of work hours on adverse events and errors in health care.
Open accessAbstract
Introduction We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.Method Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.Results All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.Discussion This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.Impact on industry Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.
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Studies from outside the United States have generally focused on nurse job satisfaction and have not quantified associations with care quality.
“Studies from outside the United States have generally focused on nurse job satisfaction and have not quantified associations with care quality (eg, Richardson and colleagues 8,17 ).”
From Nurses’ Shift Length and Overtime Working in 12 European Countries: The Association With Perceived Quality of Care and Patient Safety (2014) · cites this paper as [17]
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- Authors
- Olds, D. M., & Clarke, S. P.
- Affiliations
- University of Pennsylvania (US)
- University Health Network (CA)
- Corresponding author
- Olds, Danielle M.
- Venue
- Journal of Safety Research
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 41
- Issue
- 2
- Pages
- 153-162
- ISSN
- 0022-4375 (ISSN-L)
- PMC
- PMC2910393
- OpenAlex
- W1968026351
- Cited by
- 211
- References
- 31
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 11 · 2023: 11 · 2022: 15 · 2021: 18 · 2020: 15 · 2019: 21 · 2018: 20 · 2017: 16 · 2016: 12 · 2015: 14 · 2014: 10 · 2013: 8 · 2012: 9
- FWCI
- 13.27
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Safety Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p30nr005043-10)
- National Institute of Nursing Research (P30-NR-005043, R01NR004513, T32NR007104)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- adverse events, medical errors, needlestick injuries, occupational injuries, patient falls, nosocomial infections, medication errors, mandatory overtime, nurse safety, patient safety, registered nurses
- MeSH terms
- Accidental Falls, Accidents, Occupational, Adult, Cross Infection, Delivery of Health Care, Female, Humans, Male, Medication Errors, Middle Aged, Nurses, Pennsylvania, Surveys and Questionnaires, Risk Factors, Work Schedule Tolerance, Logistic Models, Workload, Needlestick Injuries, Medical Errors
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