Leadership Strategies to Reduce Risks for Nurse Night Shift Workers

Abstract

The purpose of this systematic review is to identify leadership strategies to help mitigate risks associated with nurse night shift work. An electronic literature search for “Strategies to reduce risks for nurse night shift workers” was conducted using Pubmed, CINAHL, and Health Source: Nursing/Academic Edition databases. Inclusion criteria used was English language, full text available, and published dates between January 1, 2005 and May 1, 2015. Based on the search criteria a total of 107 articles were identified. Abstracts for the articles were reviewed for relevance and duplicate citations removed for a total of 16 studies being included in the review. Several strategies were identified that helped increase transparency and control of shift scheduling. One idea was the utilization of open-shift management technology to allow staff to volunteer for open shifts within a multi-site healthcare system. This idea fit well with the self-scheduling model. The literature indicated that that level of control over schedule contributed to improved health and sense of well-being for shift workers. The individual factor of hardiness was found to have protective effects for shift work tolerance. Furthermore, specific guidelines for fatigue management and practice guidelines for shift management standards help reduce risk for staff and patients. Education for staff regarding health risks, sleep management, and circadian approaches were addressed as leadership responsibilities. Other shift work strategies that produced positive outcomes focused on the rate, duration, and direction of rotating shifts.