Issues involved in introducing the 12-hour shift

Abstract

The requirement to ensure that practice is evidence-based, means that all aspects of the structure, process and outcome of nursing care need to be subjected to critical review. This report attempts to do this in regard to the 12-hour shift pattern. Twelve-hour shifts are being introduced by an increasing number of managements, a practice which has raised concerns since there is some evidence indicating that 12-hour shifts affect the amount of care patients receive, and that there are possible links between length of shift worked, nurses' stress and fatigue levels and the impact these might have on the quality of care. This review discusses the main effects of the change in shifts on nurses and patients alike. The review focuses on studies since 1980 and on studies carried out in the United Kingdom. The search produced a considerable number of references; however, only those which met the inclusion criteria are included in this paper; a complete list is available on request. Much of the published work currently available lacks rigour. Yet, this is an important topic on which sound information is needed to inform decision-making.