wsna meeting 08.ppt [read-only]gue d,,, rn, faan ofessor ia school of nursingia school of nursing....
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FatiFatiFatiFatiAnn E. Rogers PhAnn E. Rogers Phg
Associate Prniversity of Pennsylvani
gAssociate Pr
niversity of Pennsylvaniniversity of Pennsylvaniniversity of Pennsylvani
guegueguegueD, RN, FAAND, RN, FAAN, ,
rofessoria School of Nursing
, ,rofessoria School of Nursingia School of Nursingia School of Nursing
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ResearchResearchResearch Research on Breakson Breakson Breakson Breaks
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DefiniDefini
Short work breaks (coShort work breaks (co(are usually 5-20 minu
(are usually 5-20 minu
Meal breaks (lunch b30 i t lMeal breaks (lunch b30 i t l30 minutes or longer consuming a meal30 minutes or longer consuming a mealgg
itionsitions
offee or tea breaks) offee or tea breaks) )utes long
)utes long
reak) are breaks of f th freak) are breaks of f th ffor the purpose of for the purpose of
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ResearchResearchRegular rest breaks are Regular rest breaks are in controlling the accumwith prolonged task perfin controlling the accumwith prolonged task perfp g pcontinuous work
p g pcontinuous work
Field studies of workers pilots to data entry persoField studies of workers pilots to data entry persop y pbreaks can improve perfsubjective fatigue.
p y pbreaks can improve perfsubjective fatigue.subjective fatigue.
One study of forestry wo
subjective fatigue.
One study of forestry woy yand tea breaks reduced decrease the risk of acc
y yand tea breaks reduced decrease the risk of acc
h Showsh Showsbelieved to be effective believed to be effective ulation of risk associatedformance e.g., 2 hr of ulation of risk associatedformance e.g., 2 hr of g ,g ,
ranging from airline onnel show that short ranging from airline
onnel show that short formance and reduce formance and reduce
orkers showed that rest orkers showed that rest fatigue but did not
cidentsfatigue but did not
cidents
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Research ShResearch Sh
The frequency and timinmore important than theThe frequency and timinmore important than thepbreak.
pbreak.
hows (cont.)hows (cont.)
ng of work breaks may be actual duration of the ng of work breaks may be actual duration of the
-
Research ShResearch Sh
The frequency and timinmore important than theThe frequency and timinmore important than themore important than thebreak.more important than thebreak.
- Shorter, more frequenproductivity and redu
- Shorter, more frequenproductivity and reduproductivity and redu
- Muscle fatigue, lowertiti t i i j i
productivity and redu- Muscle fatigue, lower
titi t i i j irepetitive strain injuriereduced when short arepetitive strain injuriereduced when short aminutes or 5 minutesscheduled breaksminutes or 5 minutesscheduled breaks
hows (cont.)hows (cont.)
ng of work breaks may be actual duration of theng of work breaks may be actual duration of thee actual duration of the e actual duration of the
nt breaks improve ce fatiguent breaks improve ce fatiguece fatiguer extremity discomfort,
d t i
ce fatiguer extremity discomfort,
d t ies, and eyestrain was additional breaks (e.g., 3es, and eyestrain was additional breaks (e.g., 3) were added to regularl) were added to regularl
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Research ShResearch Sh
W k d d llW k d d llWork demands usuallybreaks are scheduledWork demands usuallybreaks are scheduledbreaks are scheduled worker feels fatiguedbreaks are scheduled worker feels fatigued
hows (cont.)hows (cont.)
d i if kd i if ky determine if work or taken when they determine if work or taken when theor taken when the or taken when the
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Research ShResearch Sh
W k d d llW k d d llWork demands usuallybreaks are scheduled Work demands usuallybreaks are scheduled worker feels fatigued
lf d k d i di id
worker feels fatiguedlf d k d i di idself-paced work and individ
schedules usually associatperformance decrements
self-paced work and individschedules usually associatperformance decrementsperformance decrementsworkers rarely judge their fperformance decrementsworkers rarely judge their foften delay taking a break declines in performance anbecome intolerable
often delay taking a break declines in performance anbecome intolerablebecome intolerablebecome intolerable
hows (cont.)hows (cont.)
d i if kd i if ky determine if work or taken when the y determine if work or taken when the
d ll d t i d b kd ll d t i d b kdually determined break ted with greater fatigue and dually determined break ted with greater fatigue and
fatigue levels accurately andfatigue levels accurately anduntil there are significant nd/or subjective fatigue has until there are significant nd/or subjective fatigue has
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ypical Breaypical Breaypical Breaypical Breaak Scheduleak Scheduleak Scheduleak Schedule
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union counion co
10 15 i t ff b10 15 i t ff b10-15 minute coffee bre10-15 minute coffee bre
If work longer than 5 or day meal break of 30 60If work longer than 5 or day meal break of 30 60day meal break of 30-60day meal break of 30-60
People in service profesmeal period e g 30 minPeople in service profesmeal period e g 30 minmeal period e.g., 30 minand their meal period m
h d l d li l t
meal period e.g., 30 minand their meal period m
h d l d li l tscheduled earlier or latetraditional meal periodsscheduled earlier or latetraditional meal periods
ontractsontracts
k t hk t heak every two hourseak every two hours
6 hours, usually given a0 minutes6 hours, usually given a0 minutes0 minutes0 minutes
ssions often have a shornutesssions often have a shornutesnutes, ay be
th
nutes, ay be
ther than er than
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ws Governiws Governiws GoverniMeal P
ws GoverniMeal PMeal PMeal P
ing Break aing Break aing Break aPeriodsing Break a
PeriodsPeriodsPeriods
-
Legal RequiremLegal Requirem
Th f d lTh f d lThere are no federal remployees be given mThere are no federal remployees be given mp y gp y g
However, if the emplo20 minutes) this is conHowever, if the emplo20 minutes) this is con20 minutes) this is conmust be compensatedskip their meal period
20 minutes) this is conmust be compensatedskip their meal periodskip their meal periodrelated duties, or havei t t d t b
skip their meal periodrelated duties, or havei t t d t binterrupted must be pabreak.interrupted must be pabreak.
ments: Federalments: Federal
i t th ti t th trequirements that meal or coffee breaksrequirements that meal or coffee breaks
oyer offers short breaknsidered work time anoyer offers short breaknsidered work time annsidered work time and. Hourly employees to perform any work
nsidered work time and. Hourly employees to perform any work to perform any work
e their meal break id f th ti
to perform any work e their meal break
id f th tiaid for the entire meaaid for the entire mea
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Legal RequireLegal Require
Eight states require paEight states require pag q pnurses are specifically with Colorado’s statute
g q pnurses are specifically with Colorado’s statutewith Colorado s statutemeal periods, and Illinoroom attendants in cou
with Colorado s statutemeal periods, and Illinoroom attendants in couroom attendants in couinhabitantsroom attendants in couinhabitants
19 other states also halength and timing of me19 other states also halength and timing of melength and timing of meregulations in Nebraska
l d i f
length and timing of meregulations in Nebraska
l d i femployed in manufactuemployed in manufactu
ements: Stateements: State
id rest periods, althougid rest periods, althougp , gexcluded from complia
es requiring rest breaks
p , gexcluded from complia
es requiring rest breakses requiring rest breaksois laws only apply to hunties of over 3 million
es requiring rest breaksois laws only apply to hunties of over 3 millionunties of over 3 million unties of over 3 million
ave provisions governineal breaks although thave provisions governineal breaks although theal breaks, although tha apply only to workers
i l
eal breaks, although tha apply only to workers
i luring plantsuring plants
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StateState
alifornia Paid 10-minute rest periti th fportion thereof
entucky Ten-minute paid rest peraddition to regularly schaddition to regularly sch
innesota Paid adequate rest perioto utilize nearest convento utilize nearest conven
Nevada Paid 10 minute rest perifraction thereof
Oregon Paid 10-minute rest periportion thereof in 1 workaddition to regular mealaddition to regular meal period or deducted fromreduce the length of the
ashington Paid 10-minute rest perimay not be required to wperiod
RequirementRequirementRequirementRequirement
iod for each 4 hours worked or major
riod every 4 hour work period. Must beduled meal periodeduled meal period
od within each 4 consecutive hours ofnient restroomnient restroomod for each 4 hours worked or major
iod for every 4-hour segment or majork period. Rest period must be taken inperiod not to be added to usual meaperiod, not to be added to usual mea
m beginning or end of work periods to work period
iod for each 4-hour work period. Empwork more than 3 hours without a rest
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Required byRequired by
State
lifornia 1/2 hour after 5 hours, excethan 6 hours. On-duty meapermitted only when naturepermitted only when naturethere is a written agreemenagreement at anytime
necticut 1/2 hour after 2 hours and work more than 7.5 consec
laware 1/2 hour after 2 hours and work more than 7.5 consecNote: statute also contains be waived if continuous natemployees to respond to utimes;requires employees ttimes;requires employees tconditions
y State Lawy State Law
Requirement
ept when workday will be completed inal period counted as time worked and e of work prevents relief from all dutiese of work prevents relief from all dutiesnt between parties. Employees may re
before the last 2 hours for employees cutive hours
before the last 2 hours for employees cutive hours.
language that permits this requiremeg g p qture of employers business requires nusual and urgent conditions at all to be paid for meal periods under thosto be paid for meal periods under thos
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Required byRequired by
State
t k R bl ff d t tientucky Reasonable off-duty timespecial circumstances, bebreaks and snack times n
Maine 1/2 hour after 6 consecutwhere nature of work allowhere nature of work alloduring the workday
nnecticut 1/2 hour after 2 hours anwork more than 7.5 cons
sachusetts 1/2 hour if work is more tnnesota Sufficient unpaid time for
or moreN d 1/2 h if k i f 8Nevada 1/2 hour if work is for 8 co
New ampshire
1/2 hour, after 5 consecuto eat while working and
y State Lawy State Law
Requirement
ll 1/2 h b h te, normally 1/2 hour, can be shorter unetween 3rd and 5th hour of work. Cofnot to be included in meal periodp
tive hours, except in cases of emergenows employees to take frequent breakows employees to take frequent break
d before the last 2 hours for employeep yecutive hours
han 6 hoursr employees who work 8 consecutive h
ti hontinuous hourstive hours unless it is feasible for emppermitted by employer
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Required byRequired by
State
ew York 30 minutes noonday perioew York 30 minutes noonday periothan 6 hours that extend oAn additional 20 minutes employed on shifts startinNon-factory workers, 45-memployed for more than semployed for more than s
th Dakota 1/2 hour if desired on eac
Oregon 1/2 hour relief from all dutbetween the 2nd and 5th Note: there is also additioNote: there is also additioable to show that employenature of work prohibits thmaintaining a regularly sc
y State Lawy State Law
Requirement
od for employees who work shifts of mod for employees who work shifts of mover the noon day meal period.between 5 p.m. and 7 p.m. for those
ng before 11 am and ending after 7 p.mminutes midway in the shift for those six hours between 1 am and 6 amsix hours between 1 am and 6 am
ch shift exceeding 5 hours
ties for each work period of 6-8 hours,work hours for shifts of 7 hours or mo
onal language regarding an employeronal language regarding an employer ee has indeed received the time speche employer from establishing and cheduled meal period.
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Required byRequired by
StateState
de Island All employees are entitledwork shift and 30 minuteswork shift and 30 minutes
nnessee 1/2 hour for employees sc
shington 1/2 hour if work period mogiven less than 2 hours orthe shift. Counted as workpremises. An additional 1employee works 3 or moreemployee works 3 or more
y State Lawy State Law
RequirementRequirement
d to a 20 minute meal period within a 6within an 8 hour work shiftwithin an 8 hour work shift
cheduled to work 6 hours or more
ore than 5 consecutive hours, not to ber more than 5 hours after the beginnink time if employee required to remain o/2 hour before or during overtime if e hours beyond regular workdaye hours beyond regular workday
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ExtendeExtendeAlthough extended shifts al i f d tAlthough extended shifts al i f d tlaws remain focused on a tperiod laws remain focused on a tperiod
Most authorities recommenwork breaks when employeMost authorities recommenwork breaks when employework breaks when employe
Little empirical data availab
work breaks when employe
Little empirical data availabpduration, and frequency of employees work extended
pduration, and frequency of employees work extended p y
-a study of truck and bus drivthird, 3-hour break did not a
p y-a study of truck and bus driv
third, 3-hour break did not athird, 3 hour break did not adecrease the increasing trethird, 3 hour break did not adecrease the increasing tre
d Shiftsd Shiftsre becoming commonplacet diti l 8 h kre becoming commonplacet diti l 8 h ktraditional 8-hour work traditional 8-hour work
nd additional, more frequenees work extended shiftsnd additional, more frequenees work extended shiftsees work extended shifts
ble regarding the timing,
ees work extended shifts
ble regarding the timing, g g g,breaks required when shifts.
g g g,breaks required when shifts.vers found that the addition of a aid physiologic recovery orvers found that the addition of a aid physiologic recovery oraid physiologic recovery or end for errors after 9 hours of woaid physiologic recovery or end for errors after 9 hours of wo
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Hospital Staff Nand Meal
Hospital Staff Nand Mealand Mealand Meal
A d t l d t tA d t l d t tAnecdotal data, recent bargaining agreementsAnecdotal data, recent bargaining agreementscases suggest that nursregularly sacrificing thecases suggest that nursregularly sacrificing theg y gbreak periods to provid
g y gbreak periods to provid
Nurses: Break l PeriodsNurses: Break l Periodsl Periodsl Periods
ll till ticollective s, and court collective
s, and court ses are
eir meal and ses are
eir meal and e patient caree patient care
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Hospital Staff Nand Meal
Hospital Staff Nand Meal
Anecdotal data recentAnecdotal data recent
and Mealand MealAnecdotal data, recent bargaining agreements
t th t
Anecdotal data, recent bargaining agreements
t th tcases suggest that nursregularly sacrificing thecases suggest that nursregularly sacrificing theg y gbreak periods to provid
Nine out of 10 nurses we obse
g y gbreak periods to provid
Nine out of 10 nurses we obseNine out of 10 nurses we obselunches in much less time thanpostponed taking personal bre
Nine out of 10 nurses we obselunches in much less time thanpostponed taking personal bregthe care they felt their patientsTucker and Edmondson, 2003
gthe care they felt their patientsTucker and Edmondson, 2003
Nurses: Break l PeriodsNurses: Break l Periodscollectivecollective
l Periodsl Periodscollective
s, and court collective
s, and court ses are
eir meal and ses are
eir meal and e patient care
erved they ate their
e patient careerved they ate theirerved …they ate their n allotted and eaks in order to provide
erved …they ate their n allotted and eaks in order to provide s deserved (pg 63, 3)s deserved (pg 63, 3)
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Hospital Staff Nand Meal
Hospital Staff Nand Mealand Mealand Meal
Anecdotal data, recent bargaining agreementsAnecdotal data, recent bargaining agreementsg g gcases suggest that nursregularly sacrificing the
g g gcases suggest that nursregularly sacrificing theregularly sacrificing thebreak periods to providregularly sacrificing thebreak periods to provid
Nine out of 10 nurses we obselunches in much less time thanpostponed taking personal bre
Nine out of 10 nurses we obselunches in much less time thanpostponed taking personal brepostponed taking personal brethe care they felt their patientsTucker and Edmondson, 2003
postponed taking personal brethe care they felt their patientsTucker and Edmondson, 2003
Not unique to the US. Faugie125 English nurses working hiNot unique to the US. Faugie125 English nurses working hi
Nurses: Break l PeriodsNurses: Break l Periodsl Periodsl Periods
collective s, and court collective
s, and court ,ses are
eir meal and
,ses are
eir meal andeir meal and e patient care
eir meal and e patient care
erved …they ate their n allotted and eaks in order to provide
erved …they ate their n allotted and eaks in order to provideeaks in order to provide s deserved (pg 63, 3)
eaks in order to provide s deserved (pg 63, 3)
r et al’s study of gh intensity units reported that mr et al’s study of gh intensity units reported that m
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Hospital Staff Nand Meal Pe
Hospital Staff Nand Meal Peand Meal Peand Meal Pe
Some hospitals are givbreaks and meal periodSome hospitals are givbreaks and meal periodbreaks and meal periodrequiring them to be takbreaks and meal periodrequiring them to be takvery odd timesvery odd times
Nurses: Break riods (cont.)Nurses: Break riods (cont.)riods (cont.)riods (cont.)
ing nurses ds b ting nurses ds b tds but ken at ds but ken at
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Hospital Staff Nand Meal Pe
Hospital Staff Nand Meal Peand Meal Peand Meal Pe
Some hospitals are givbreaks and meal perioSome hospitals are givbreaks and meal periobreaks and meal periorequiring them to be ta
dd ti
breaks and meal periorequiring them to be ta
dd tivery odd timesA hospital in Anchorage AK gave n
very odd timesA hospital in Anchorage AK gave ng glunch break but did not allow staff nworked 12 hr day shifts to take it un
g glunch break but did not allow staff nworked 12 hr day shifts to take it un
Nurses: Break riods (cont.)Nurses: Break riods (cont.)riods (cont.)riods (cont.)
ving nurses ods butving nurses
ods butods but aken at ods but aken at
urses a 30-minute urses a 30-minute nurses who ntil 3 or 4 pm. nurses who ntil 3 or 4 pm.
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Hospital Staff Nand Meal Pe
Hospital Staff Nand Meal Peand Meal Peand Meal Pe
Some hospitals are givbreaks and meal perioSome hospitals are givbreaks and meal periobreaks and meal periorequiring them to be ta
dd ti
breaks and meal periorequiring them to be ta
dd tivery odd timesA hospital in Anchorage AK gave n
very odd timesA hospital in Anchorage AK gave nlunch break but did not allow staff nworked 12 hr day shifts to take it un
A th h it l th i t ff
lunch break but did not allow staff nworked 12 hr day shifts to take it un
A th h it l th i t ffAnother hospital gave their staff nubreak for every four hours they worinsisted that they take hourly break
th th 10 i t b k A
Another hospital gave their staff nubreak for every four hours they worinsisted that they take hourly break
th th 10 i t b k Arather than one 10-minute break. Atook a non-scheduled break to use was considered to be his/her break
rather than one 10-minute break. Atook a non-scheduled break to use was considered to be his/her break
Nurses: Break riods (cont.)Nurses: Break riods (cont.)riods (cont.)riods (cont.)
ving nurses ods butving nurses
ods butods but aken at ods but aken at
urses a 30-minute urses a 30-minute nurses who ntil 3 or 4 pm.
10 i t
nurses who ntil 3 or 4 pm.
10 i trses a 10-minute rked, but s of 2-3 minutes
A d if
rses a 10-minute rked, but s of 2-3 minutes
A d ifAnd if a nurse the restroom, it
k for that hour.
And if a nurse the restroom, it
k for that hour.
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ndings from tndings from tgaff Nurse Fat
gaff Nurse Fata u se at
nd Patient Safa u se at
nd Patient Safnd Patient Safnd Patient Saf
the the tigue tigue t guefety Studyt guefety Studyfety Studyfety Study
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gStudy: Pa
gStudy: Pa
895 participants were prfemale (93%), middle-ag895 participants were prfemale (93%), middle-ag( ), gage 44.5 ±8.3, range 22Caucasian (82%)
( ), gage 44.5 ±8.3, range 22Caucasian (82%)Caucasian (82%)
Worked at least 36 hour
Caucasian (82%)
Worked at least 36 houro ed at east 36 ou
Were unit based and em
o ed at east 36 ou
Were unit based and emhospitalhospital
Were members of the Athe AACN (n=502)Were members of the Athe AACN (n=502)
rticipantsrticipants
redominately ged (mean redominately ged (mean g (2-66 years) and g (2-66 years) and
rs/weekrs/weeks/ ee
mployed by a
s/ ee
mployed by a p y yp y y
ANA (n=393) or ANA (n=393) or
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gStudy: Met
gStudy: Met
Logbooks were used to colabout the hours worked (scLogbooks were used to colabout the hours worked (scactual hours), breaks and movertime, drowsiness on dud i i h ll i f
actual hours), breaks and movertime, drowsiness on dud i i h ll i fdriving home as well as infopatterns on work and
k d
driving home as well as infopatterns on work and
k dnon-work days.
Data collected on over 11 0
non-work days.
Data collected on over 11 0Data collected on over 11,0Data collected on over 11,0
thodologythodology
llect information cheduled and llect information cheduled and meal periods, uty and when
i b l / k
meal periods, uty and when
i b l / kormation about sleep/wakeormation about sleep/wake
000 work shifts000 work shifts000 work shifts000 work shifts
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The Majority of HosAre Now ScheduledThe Majority of Hos
Are Now Scheduled
ANA AANA Sample No. (%)
ASaNNo. (%) N
our shifts 150(38 3%) (1(38.3%) (1
hour shifts 230hour shifts 230(58.7%) (8
her 12(3.1%) (1(3.1%) (1
spital Staff Nurses d for 12-Hour Shiftsspital Staff Nurses d for 12-Hour Shifts
AACN TotalAACN ample o. (%)
Total Sample No. (%)o. (%) No. (%)
601 9%)
210(23 4%)1.9%) (23.4%)
436 66843686.2%)
668(74.2%)
101.9%)
22(2.4%)1.9%) (2.4%)
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Break/Meal PeriodsBreak/Meal Periods
ANA Sample
Shift Duration
≤8 5 hr > 8 5 ≥12≤8.5 hr N (%)
> 8.5, 8 5 8.5,
-
Break/Meal PeriodsBreak/Meal Periods
ANA Sample
Shift Duration
≤8 5 hr > 8 5 ≥12≤8.5 hr N (%)
> 8.5, 8 5 8.5,
-
Break/Meal PeriodsBreak/Meal Periods
ANA Sample
Shift Duration
≤8 5 hr > 8 5 ≥12≤8.5 hr N (%)
> 8.5, 8 5 8.5,
-
Break/Meal PeriodsBreak/Meal Periods
ANA Sample
Shift Duration
≤8 5 hr > 8 5 ≥12≤8.5 hr N (%)
> 8.5, 8 5 8.5,
-
Break/Meal PeriodsBreak/Meal Periods
No breaks/No breaks/meal period
ShiftDuration
ShiftDuration
s and Shift Durations and Shift Duration
% ofshifts% of
shifts
-
Break/Meal PeriodsBreak/Meal Periods
No breaks/ Break/meNo breaks/meal period
Break/mewith dutie
ShiftDuration
ShiftDuration
s and Shift Durations and Shift Duration
eal period
% ofshifts% of
shifts
eal periodes
-
Break/Meal PeriodsBreak/Meal Periods
No breaks/ Break/meNo breaks/meal period
Break/mewith dutie
ShiftDuration
ShiftDuration
s and Shift Durations and Shift Duration
eal period Break/meal period
% ofshifts% of
shifts
eal periodes
Break/meal periodwithout duties
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The Duration Meal Periods bThe Duration
Meal Periods bMeal Periods bMeal Periods b
≤8.5 hr 8 5(n=1288)
duration ofduration of and meal
s during shifts during shift
A Sample 37.4±24.6pCN Sample 28.5±18.0
of Breaks and by Shift Length*of Breaks and
by Shift Length*by Shift Lengthby Shift Length
Shift DurationShift Duration
> 8.5,
-
The Duration Meal Periods bThe Duration
Meal Periods bMeal Periods bMeal Periods b
≤8.5 hr 8 5(n=1288)
duration ofduration of and meal
s during shifts during shift
A Sample 37.4±24.6pCN Sample 28.5±18.0
of Breaks and by Shift Length*of Breaks and
by Shift Length*by Shift Lengthby Shift Length
Shift DurationShift Duration
> 8.5,
-
one assumes that appropl i d f hift l ti
one assumes that appropl i d f hift l tieal periods for shifts lastin
0.5 hr should total eal periods for shifts lastin0.5 hr should total 0 minutes (two 10 min bre30 min lunch break), and 0 minutes (two 10 min bre30 min lunch break), and ),orking between 10.5 and ave 60 minutes free during
),orking between 10.5 and ave 60 minutes free duringave 60 minutes free duringurses who worked betweeours should have ≥100 mi
ave 60 minutes free duringurses who worked betweeours should have ≥100 miours should have ≥100 mihift, how often did nurses ours should have ≥100 mihift, how often did nurses eaks?eaks?
priate breaks and b t 8 d
priate breaks and b t 8 dng between 8 and ng between 8 and
eaks and that nurses
eaks and that nurses 12. 5 hours should g the shift and that12. 5 hours should g the shift and thatg the shift, and that
en 12.5 and 14 n free during their
g the shift, and that en 12.5 and 14 n free during theirn free during their receive appropriate n free during their receive appropriate
-
pwere Qu
pwere Qu
There were 10 477 shifts tThere were 10 477 shifts tThere were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included a
There were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included aonly 991 (9.5%) included abreaks and meal periods.only 991 (9.5%) included abreaks and meal periods.
ite Rareite Rarethat werethat werethat were ng. Of these,
appropriate
that were ng. Of these,
appropriateappropriate appropriate
-
pwere Qu
pwere Qu
There were 10 477 shifts tThere were 10 477 shifts tThere were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included a
There were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included aonly 991 (9.5%) included abreaks and meal periods. only 991 (9.5%) included abreaks and meal periods.
However, having break anddurations suggestive of regHowever, having break anddurations suggestive of regmeal period, did not insurebreak free of patient responmeal period, did not insurebreak free of patient respon
ite Rareite Rarethat werethat werethat were ng. Of these,
appropriate
that were ng. Of these,
appropriateappropriate
appropriate
d meal period gular breaks in addition to ad meal period gular breaks in addition to a that nurses actually had ansibilities. that nurses actually had ansibilities.
-
pwere Qu
pwere Qu
There were 10 477 shifts tThere were 10 477 shifts tThere were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included a
There were 10, 477 shifts tbetween 8 and 14 hours loonly 991 (9.5%) included aonly 991 (9.5%) included abreaks and meal periods. only 991 (9.5%) included abreaks and meal periods.
However, having break anddurations suggestive of regHowever, having break anddurations suggestive of regmeal period, did not insurebreak free of patient responmeal period, did not insurebreak free of patient respon
- data from the AACN sample rel 211/5629 hift (3 8%) h
- data from the AACN sample rel 211/5629 hift (3 8%) honly 211/5629 shifts (3.8%) wh
to have appropriate relief from responsibilities during their shif
only 211/5629 shifts (3.8%) whto have appropriate relief from responsibilities during their shif
ite Rareite Rarethat werethat werethat were ng. Of these,
appropriate
that were ng. Of these,
appropriateappropriate
appropriate
d meal period gular breaks in addition to ad meal period gular breaks in addition to a that nurses actually had ansibilities. that nurses actually had ansibilities.
evealed there were h devealed there were h dhere nurses appeared patient care fts
here nurses appeared patient care fts
-
Association of Errorby Shift D
Association of Errorby Shift D
ANA Sample
n Break No. of
ShiftsNo. of shifts
OR(p val
with ≥1 error (%)
(p
(%)NoYes
380365
8 (2.1)4 (1.1)
1.000.52( )
(0.25NoY
13171120
51 (3.8)24 (2 4)
1.000 6Yes 1120 24 (2.4) 0.6
(0.08No 1085 61 (5 6) 1 00NoYes
1085944
61 (5.6)41 (4.4)
1.000.79
(0.26
rs and Breaks/Meals Durationrs and Breaks/Meals Duration
AACN Sample
R ue)
Break No. of Shifts
No. of shifts with (p )≥1 error
(%)
(p
02
NoYes
304224
8 (2.6)3 (1.3)
10.49
5)( )
01
NoY
930771
28 (3.0)17 (2 2)
10 601
8)Yes 771 17 (2.2) 0.60
0 No 2364 99 (4 2) 109 6)
NoYes
23641360
99 (4.2)46 (3.4)
10.80
-
Association of Errorby Shift D
Association of Errorby Shift D
ANA Sample
n Break No. of
ShiftsNo. of shifts
OR(p val
with ≥1 error (%)
(p
(%)NoYes
380365
8 (2.1)4 (1.1)
1.000.52( )
(0.25NoY
13171120
51 (3.8)24 (2 4)
1.000 6Yes 1120 24 (2.4) 0.6
(0.08No 1085 61 (5 6) 1 00NoYes
1085944
61 (5.6)41 (4.4)
1.000.79
(0.26
rs and Breaks/Meals Durationrs and Breaks/Meals Duration
AACN Sample
R ue)
Break No. of Shifts
No. of shifts with (p)≥1 error
(%)
(p
02
NoYes
304224
8 (2.6)3 (1.3) 0.4
5)( )
01
NoY
930771
28 (3.0)17 (2 2) 0 61
8)Yes 771 17 (2.2) 0.6
0 No 2364 99 (4 2)09 6)
NoYes
23641360
99 (4.2)46 (3.4) 0.8
-
Association of Errorby Shift D
Association of Errorby Shift D
ANA Sample
n Break No. of
ShiftsNo. of shifts
OR(p val
with ≥1 error (%)
(p
(%)NoYes
380365
8 (2.1)4 (1.1)
1.000.52( )
(0.25NoY
13171120
51 (3.8)24 (2 4)
1.000 6Yes 1120 24 (2.4) 0.6
(0.08No 1085 61 (5 6) 1 00NoYes
1085944
61 (5.6)41 (4.4)
1.000.79
(0.26
rs and Breaks/Meals Durationrs and Breaks/Meals Duration
AACN Sample
R ue)
Break No. of Shifts
No. of shifts with (p)≥1 error
(%)
(p
02
NoYes
304224
8 (2.6)3 (1.3) 0.4
5)( )
01
NoY
930771
28 (3.0)17 (2 2) 0 61
8)Yes 771 17 (2.2) 0.6
0 No 2364 99 (4 2)09 6)
NoYes
23641360
99 (4.2)46 (3.4) 0.8
-
gStudy: Con
gStudy: Con
Nurses frequently work during and meal periods; nurses werepatient care responsibilities du
Nurses frequently work during and meal periods; nurses werepatient care responsibilities dupatient care responsibilities duand meal periods less than haworked
patient care responsibilities duand meal periods less than haworkedworked
Although there was a significanb t hift d ti d b
worked
Although there was a significanb t hift d ti d bbetween shift duration and brefor ICU nurses, there was onlyaverage break durations
between shift duration and brefor ICU nurses, there was onlyaverage break durationsaverage break durations when nurses working 8 hr shiftcompared to those working 12
average break durations when nurses working 8 hr shiftcompared to those working 12
The median duration for breakperiods was 30 minutesThe median duration for breakperiods was 30 minutes
nclusionsnclusions
their breakse relieved of uring their breaks
their breakse relieved of uring their breaksuring their breaks lf the shifts they
uring their breaks lf the shifts they
nt relationshipk d ti
nt relationshipk d tieak duration
y a 6 minute difference betweeeak durationy a 6 minute difference betwee
ts were -hour shifts. ts were -hour shifts.
k and meal k and meal
-
gStudy: Recom
gStudy: Recom
Although skipping breaks andmay or may not lead to a signncreased risk of errors this n
Although skipping breaks andmay or may not lead to a signncreased risk of errors this nncreased risk of errors, this npractice should be actively dincreased risk of errors, this npractice should be actively di
mmendationsmmendations
d meal periods nificantly near universal
d meal periods nificantly near universalnear-universal scouraged.near-universal scouraged.
-
gStudy: Recom
gStudy: Recom
Alth h ki i b k dAlth h ki i b k dAlthough skipping breaks andmay or may not lead to a signncreased risk of errors this n
Although skipping breaks andmay or may not lead to a signncreased risk of errors this nncreased risk of errors, this npractice should be actively dincreased risk of errors, this npractice should be actively di
Nurse well-being should be anconsideration (obesity, aging wNurse well-being should be anconsideration (obesity, aging w
mmendationsmmendations
d l i dd l i dd meal periods nificantly near universal
d meal periods nificantly near universalnear-universal scouraged.near-universal scouraged.
n important workforce)n important workforce)
-
gStudy: Recom
gStudy: Recom
Alth h ki i b k dAlth h ki i b k dAlthough skipping breaks andmay or may not lead to a signncreased risk of errors this n
Although skipping breaks andmay or may not lead to a signncreased risk of errors this nncreased risk of errors, this npractice should be actively di
N ll b i h ld b
ncreased risk of errors, this npractice should be actively di
N ll b i h ld bNurse well-being should be anconsideration (obesity, aging wNurse well-being should be anconsideration (obesity, aging w
Staffing should be sufficient toand meal periods Staffing should be sufficient toand meal periods
mmendationsmmendations
d l i dd l i dd meal periods nificantly near universal
d meal periods nificantly near universalnear-universal scouraged.i
near-universal scouraged.in important
workforce)n important workforce)
o cover breaks o cover breaks
-
gStudy: Recom
gStudy: Recom
Alth h ki i b k dAlth h ki i b k dAlthough skipping breaks andmay or may not lead to a signncreased risk of errors this n
Although skipping breaks andmay or may not lead to a signncreased risk of errors this nncreased risk of errors, this npractice should be actively dincreased risk of errors, this npractice should be actively di
Nurse well-being should be anconsideration (obesity, aging wNurse well-being should be anconsideration (obesity, aging w
Staffing should be sufficient toand meal periods Staffing should be sufficient toand meal periods
Hospitals that allow nurses wobreak but do not pay them for likewise those that are located
Hospitals that allow nurses wobreak but do not pay them for likewise those that are locatedlikewise those that are locatedrequiring regular breaks may blikewise those that are locatedrequiring regular breaks may b
mmendationsmmendations
d l i dd l i dd meal periods nificantly near universal
d meal periods nificantly near universalnear-universal scouraged.near-universal scouraged.
n important workforce)n important workforce)
o cover breaks o cover breaks
ork during their lunch this time are at risk for lawsuit;
d in states
ork during their lunch this time are at risk for lawsuit;
d in statesd in states be at risk of being fined.d in states be at risk of being fined.
-
gStudy: Recomme
gStudy: Recomme
A cultural shift may be requireensure that hospital staff nursA cultural shift may be requireensure that hospital staff nursensure that hospital staff nursbreaks and do not work durinunch hour
ensure that hospital staff nursbreaks and do not work durinunch hourunch hour
Hospital staff nurses
unch hourHospital staff nurses
Managers
Patients
Managers
Patients
Data gathering and creative ischeduling may be required tData gathering and creative ischeduling may be required tscheduling may be required tbarriers associated with staffscheduling may be required tbarriers associated with staff
endations (cont.)endations (cont.)
ed in order to ses take regularly scheduleded in order to ses take regularly scheduledses take regularly scheduled
ng their ses take regularly scheduled
ng their
deas about to overcomedeas about to overcometo overcome ingto overcome ing
-
Color Color 99FF0099FF00
FF6600FF6600
336699336699336699336699
codescodes333399333399
CC3333CC3333
CC00CCCC00CCCC00CCCC00CC
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