Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using Routinely Collected Data
Table 1
Negative binomial and Poisson mixed-effects regression coefficients for the association between 12+ hour shifts and patient incidents.
Negative binomial mixed-effects regressions
Patient incidents (unadjusted)
Patient incidents (adjusted‡)
B
SE
B
SE
Proportion of long shifts
0.34
0.19
0.48
0.20
Proportion of long shifts squared
−1.02
0.54
−1.33
0.57
Proportion of long shifts cubic
0.73
0.40
1.08
0.43
AIC
BIC
AIC
BIC
AIC/BIC
101212.7
101265.6
100938.8
101027.1
Patient incidents with any harm (unadjusted)
Patient incidents with any harm (adjusted‡)
B
SE
B
SE
Proportion of long shifts
−0.09
0.30
0.01
0.32
Proportion of long shifts squared
0.76
0.86
0.54
0.95
Proportion of long shifts cubic
−0.47
0.64
−0.23
0.70
AIC
BIC
AIC
BIC
54659.9
54712.9
54609.8
54698.0
Violence against staff (unadjusted)
Violence against staff (adjusted‡)
B
SE
B
SE
Proportion of long shifts
−0.33
0.41
−0.06
0.47
Proportion of long shifts squared
−2.38
1.32
−2.74
1.54
Proportion of long shifts cubic
2.17
0.95
2.63
1.12
AIC
BIC
AIC
BIC
32452.7
32505.7
32323.0
32411.3
Self-injury (unadjusted)
Self-injury (adjusted‡)
B
SE
B
SE
Proportion of long shifts
0.77
0.45
0.83
0.48
Proportion of long shifts squared
−0.49
1.43
−0.66
1.54
Proportion of long shifts cubic
0.31
0.98
0.54
1.06
AIC
BIC
AIC
BIC
28105.2
28158.2
28007
28095.3
Disruptive behaviour (unadjusted)
Disruptive behaviour (adjusted‡)
B
SE
B
SE
Proportion of long shifts
0.75
0.57
1.03
0.55
Proportion of long shifts squared
−4
1.82
−3.83
1.77
Proportion of long shifts cubic
3.09
1.24
3.27
1.22
AIC
BIC
AIC
BIC
23062
23115
22879.1
22967.4
Poisson mixed-effects regressions
Medication management incidents (unadjusted)
Medication management incidents (adjusted‡)
B
SE
B
SE
Proportion of long shifts
0.36
0.52
0.54
0.58
Proportion of long shifts squared
−0.59
1.51
−0.72
1.75
Proportion of long shifts cubic
0.12
1.22
0.13
1.41
AIC
BIC
AIC
BIC
21903.3
21947.5
21856.9
21936.3
Falls (unadjusted)
Falls (adjusted‡)
B
SE
B
SE
Proportion of long shifts
0.23
0.55
0.19
0.56
Proportion of long shifts squared
−0.50
1.72
−0.63
1.72
Proportion of long shifts cubic
0.16
1.49
0.37
1.49
AIC
BIC
AIC
BIC
25211.8
25256.0
25207.4
25286.9
< 0.05. ‡Controlled for the number of nursing staff per bed, proportion of substantive shifts, skill-mix (registered nurses hours/registered nurses + healthcare support worker + nursing associate hours), and type of ward (physical vs. mental health).
