Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
The extended practice hours in nursing practice has become a common phenomenon and even popular among nursing personnel at various hospitals. According to survey data from multifarious hospitals in the United State, 80% of surveyed nurses admitted to preferring such long working hours whereas hospitals supported such practices via their scheduling behaviors (Stimpfel, Sloane, & Aiken, 2013). Nevertheless, as the percentage of nurses working more than twelve hours has increased, a noticeable decrease in patient dissatisfaction with care has become evident. Moreover, those nurses working for more than 12 hours demonstrate a double propensity to commit medical errors due to burnouts and dissatisfaction as compared to their colleagues working shorter shifts (Dall’Ora et al., 2015). Therefore, the practice of exte
Application 1 Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
nded working hours in hospitals should become regulated in order to ensure that quality patient care exists. To this end, establishing policies that regulate working hours in a manner akin to those of physicians may become necessary. In addition, other measures such as creation of a workplace culture that respects nurses’ time off and vacations, encourages nurses to promptly leave their workstations upon the completion of their shifts, and permits them to reject overtime work without retribution may be warranted.
Even as evidence mounts on the disadvantages of long working hours vis-a-vis the quality of care, research has supported the existence of such policies due to their apparent advantages to hospitals. According to scholarship on the issue, the longer working hours leads to reduction in the handing off process as only two nurses are required to complete the procedure as opposed to three in the 8-hour shift. Consequently, nurses will be subjected to less reports and less miscommunication chances hence possible errors. Further, Everhart et al. (2013) postulate that longer working hours will positively impact the financial performance of hospitals due to the reduction of the overall hospital costs. Also, other literature material opine that longer working hours implies better work-life balance for nurses as the flexibility offered may allow them to pursue further education, elect extra shifts and even raise a family.
Nevertheless, whereas the advantages accrued to health care facilities and to a small degree nurses cannot be doubted, the first responsibility of nurses it towards patient care. In this front, long working hours have jeopardized
Application 1 Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project
the safety of patients and the welfare of nurses. Rhéaume and Mullen (2018) posit that nurses who work more than 12 hours rate the standard of care delivered in their jurisdictions as poor. These longer working hours also predisposes them to commission of medical errors while the fatigue associated with the culture also influences their performance. Further, the impact of longer working hours on cognition of nurses is negative due to sleep deprivation that they experience (Dall’Ora et al., 2015). As a result of this, nurses do not perform to their optimal potential thereby affecting the quality of care that they offer. Also, contrary to the evidence adduced in support of this practice culture, extended working hours lead to job dissatisfaction. The existence of this phenomenon has increased the rate of nursing turnover in health care facilities, which defeats the financial motives behind the decision by various facilities to encourage the practice. Evidently, the practice of longer working hours has more disadvantages that advantages. As such, stratagems such as adopting the physical-oriented policies and changing organizational culture need to be operationalized in hospitals in order to address the matter.
References
Dall’Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, A. (2015). Association of 12 h shifts and nurses’ job satisfaction, burnout and intention to leave: Findings Fr. BMJ Open, 5(9), e008331.
Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets. Health care management review, 38(2), 146-55.
Rhéaume, A., & Mullen, J. (2018). The impact of long work hours and shift work on cognitive errors in nurses. Journal of Nursing Management, 26(1), 26–32. https://doi.org/10.1111/jonm.12513
Stimpfel, A. W., Sloane, D. M., & Aiken, L. H. (2013). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health affairs (Project Hope), 31(11), 2501-9.