WICHITA FALLS, Texas – A new report urges nursing administrators to take several steps to improve patient care during “off-peak” hours, aiming to end a phenomenon documented for decades: higher complication rates and adult and infant mortality rates on nights and weekends.
Several studies have verified that the problem exists, but this time, a project funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative set out to identify measures that nursing administrators could implement to address it.
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Their preliminary results, published in the March issue of the Journal of Nursing Administration (“Expanding What We Know About Off-peak Mortality in Hospitals”), show that nurses’ work environment during off-peak hours plays a significant role in mortality.
Specifically, the study found that nurses in hospitals that allow them to work only weekend shifts for full pay and benefits are less familiar with their institutions’ initiatives and their priorities in patient care, because those priorities are stressed more during peak hours.
“The majority of hours worked by nurses are off-peak, so understanding their experiences is crucial to understanding – and thereby addressing – the disparities in patients’ experiences during those hours,” said Patti Hamilton, principal investigator and dean of graduate studies at Midwestern State University.
“As the health care providers who work most often at the bedside and provide much of the hands-on care, nurses play an important role in providing care and in improving the quality of care,” she added. “Already, we have identified some ways in which nurse administrators can mitigate the possible reasons for these disparities.”
vOther recommendations include:
- Being conscious of the fact that the majority of hours nurses work are “off-peak,” and scheduling programs accordingly.
- Involving nurses from every shift in planning and work-process evaluation, with the knowledge that some peak-hour solutions could adversely affect off-peak nurses.
- Collecting performance data in a way that allows for comparing that data across days of the week and times, so issues specific to peak and off-peak times can be addressed.
- Proactively addressing nurse-physician relations in the hospital, which may be more strained during off-peak times.
More information about the study is available at www,nursingopen247.
