The Effect of Off-peak Hospital Environments on Nurses' Work: an Institutional Ethnography

Research shows that patients admitted to hospitals during "off-peak" hours, like evenings and weekends, experience more health problems. Led by Patti Hamilton and Gretchen Gemeinhardt, researchers at Midwestern State University, studied the differences in the ways nurses provide care during peak and off-peak times and how managerial, economic and health care policies influence nurses' work environments, actions and judgments during those periods. The team conducted interviews with more than 70 nurses and other health care providers and executives in Texas and found that 64% of hours worked by nurses are off-peak and communication with other providers is more difficult during those shifts. Their preliminary results, published in the March 2010 Journal of Nursing Administration ("Expanding What We Know About Off-peak Mortality in Hospitals"), show that nurses' "off-peak" work environments play a significant role in the increased patient mortality during these time periods. The study provides new knowledge of the effects of managerial productivity tracking on the nursing workplace and patient outcomes. Further, the study reveals how state-mandated nurse staffing policies can increase rather than decrease off-peak nurses' work intensity and result in less time to care for patients. The researchers have identified key strategies to mitigate off-peak risks for patients.

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Health care workforce data (R8)
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