Association Between Night-Shift Schedules, Nurse WellBeing, and Perceived Patient Care Quality Among ICU Nurses: A Cross-Sectional Study
Abstract
Background/Aim: Night and rotating shift work are inherent to 24/7 intensive care units (ICUs), but they disturb circadian rhythms, impact sleep, and increase physiological and cognitive strain in nurses. These disruptions are associated with tiredness, reduced work performance, and increased risks to patient safety. This study aimed to evaluate the impact of night shift schedules on ICU nurses’ physical health, psychological well-being, job performance, and perceptions of the quality of patient care. Evidence from international studies was used to put findings into context.
Methods: The researchers conducted a descriptive, cross-sectional, convenience study of ICU nurses from 10 tertiary hospitals, using a structured survey created by the researchers. The survey included five components: demographic factors, physical health, psychological and emotional factors, work performance, and perceived quality of patient care. The researchers assessed questionnaire reliability using Cronbach's alpha (Insert Alpha Value) and test-retest reliability (Insert Test-Retest Value). The researchers conducted descriptive statistics, correlation, chi-square, and regression (p<0.05) analyses using the most recent version of IBM SPSS Statistics.
Results: of the 123 ICU nurses surveyed, 91.1% work the night shift. Approximately 88.7% of participants reported having difficulty falling asleep. Night-shift nurses had high levels of musculoskeletal strain, including occupational back injuries (56.5%), and back pain, in addition to having high levels of psychological distress, including 47.6% reporting stress, 83.9% reporting emotional disturbances, and 69.4% reporting interpersonal workplace conflicts. Fatigue was strongly associated with self-reported nursing errors (59.7%) and missed care (54.8%). Night-shift nurses reported family conflict in 75.0% of cases. These risks were exacerbated by a lack of organizational support and a lack of leadership responsiveness.
Conclusion: The night and rotating shifts in ICUs impose critical burdens on nurse well-being and patient safety. Evidence-based scheduling changes, structured rest protocols, environmental changes, increased organizational support, and dedicated mental health services are needed to protect nurses’ health, sustain performance, and reduce clinical errors.
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