wsna meeting 08.ppt [read-only]gue d,,, rn, faan ofessor ia school of nursingia school of nursing....

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

ResearchResearchResearch Research on Breakson Breakson Breakson Breaks

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

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

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


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


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


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


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


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


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

ypical Breaypical Breaypical Breaypical Breaak Scheduleak Scheduleak Scheduleak Schedule

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

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

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

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

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


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


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


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


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.


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


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

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

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



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)


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

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



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


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.



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


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.

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

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

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

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%)

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,


No breaks/No breaks/meal period

ShiftDuration

ShiftDuration

s and Shift Durations and Shift Duration

% ofshifts% of

shifts


No breaks/ Break/meNo breaks/meal period

Break/mewith dutie

ShiftDuration

ShiftDuration


eal period

% ofshifts% of

shifts

eal periodes


No breaks/ Break/meNo breaks/meal period

Break/mewith dutie

ShiftDuration

ShiftDuration


eal period Break/meal period

% ofshifts% of

shifts

eal periodes

Break/meal periodwithout duties

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 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


appropriate


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 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


appropriate


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


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



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


Nurse well-being should be anconsideration (obesity, aging wNurse well-being should be anconsideration (obesity, aging w


d l i dd l i dd meal periods nificantly near universal


n important workforce)n important workforce)

gStudy: Recom

gStudy: Recom


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



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



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




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

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codescodes333399333399

CC3333CC3333

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wsna meeting 08.ppt [read-only]gue d,,, rn, faan ofessor ia school of nursingia school of nursing....

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