Schedule Change for Nurse Managers

Recruiting at 1 trial location

Overseen By Jian Li, MD, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Ambulatory care, Less than 30 FTEs, Part time, Less than 5 days, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

50 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to explore how working a 4-day schedule impacts nurse manager wellbeing and job performance. The main questions it aims to answer are: * Do those working 4-days have improved wellbeing with reduced levels of burnout and work/family conflict when compared to those in the control group? * Do levels of sleep, heart rate variability, and physical activity significantly differ between those working the 4-day schedule change and those in the control group? * Are nurse manager satisfaction, patient satisfaction, and patient quality outcomes different among those working the 4-day schedule change and those in the control group? Researchers will compare those working the 4-day schedule change to those working the standard 5-day schedule to determine causality between the intervention and the outcomes. Participants will: * Complete an initial visit to learn about the study. * Begin wearing an OURA ring, which will collect data on physical activity, sleep, and heart rate variability. They will need to download the Oura Ring app on their phone and log in weekly to sync data so that the researchers may access it. * Complete the first survey on the online REDCap platform (baseline). * Begin the work schedule that was assigned to them. * Clock in and out of work each shift. * Take the follow-up survey online (month 3). * Take the final survey online (month 6).

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. However, since the study focuses on work schedules and wellbeing, it's unlikely that medication changes are required.

What data supports the effectiveness of the treatment Work Time Schedule Changes, 4-Day Workweek, Flexible Scheduling, Compressed Work Schedule?

Research suggests that alternative work schedules, like compressed work weeks, can improve nurses' satisfaction with their work schedules and perceived patient care quality, while also reducing interference with their personal lives. ^{1 2 3 4 5}

Is changing nurse work schedules safe for nurses?

Research shows that shift work can cause sleep disorders and health issues, but it is not a direct risk factor for nurses' health or patient safety. Allowing nurses to choose their shifts may help them adapt better, and self-scheduling could improve their work environment. ^{1 2 4 6 7}

How does the treatment 'Work Time Schedule Changes' differ from other treatments for nurse managers?

The 'Work Time Schedule Changes' treatment is unique because it focuses on altering work schedules to improve nurse managers' work-life balance, unlike traditional treatments that may not address scheduling. This approach includes options like a 4-day workweek and flexible scheduling, which aim to reduce burnout and improve job satisfaction by allowing more personal time and flexibility. ^{8 9 10 11 12}

Research Team

Jian Li, MD, PhD

Principal Investigator

University of California, Los Angeles

Eligibility Criteria

This trial is for nurse managers who are currently working and have not had any recent changes to their work schedule. They must be willing to wear an OURA ring to track health data, use the Oura Ring app, and complete online surveys. Those with a history of altering their work hours or unable to commit to the study's duration are excluded.

Inclusion Criteria

Currently working at either Ronald Regan UCLA Medical Center or UCLA Medical Center Santa Monica

In the acute care setting

Currently employed as a full-time nurse manager

Exclusion Criteria

I work less than 5 days a week.

I work in a place where patients can walk in for treatment.

I work part-time.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Participants complete an initial visit to learn about the study, begin wearing an Oura Ring, and complete the first survey on the REDCap platform.

1 week

1 visit (in-person)

Intervention

Participants begin the assigned work schedule (4-day or 5-day) and continue wearing the Oura Ring, syncing data weekly.

6 months

Remote data collection

Follow-up

Participants complete follow-up surveys online at month 3 and month 6 to assess wellbeing and job performance.

6 months

2 visits (virtual)

Treatment Details

Interventions

• Work Time Schedule Changes

Trial Overview The study is testing if changing nurse managers' schedules from the standard 5-day week to a condensed 4-day week can improve wellbeing, reduce burnout, enhance sleep quality, increase physical activity levels, and positively affect job satisfaction as well as patient care outcomes.

Participant Groups

Group I: Intervention Group Experimental Treatment 1 Intervention

The intervention group will begin working only four days a week as a schedule change.

Group II: Control Group Active Control 1 Intervention

The control group will continue to work five days per week, receiving standard practice for the schedule policies at the participating study sites.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Findings from Research

Working more than 12 hours in a single day and over 40 hours in a week negatively impacts patient outcomes, highlighting the risks associated with excessive nurse work hours.

The review emphasizes the need for better management of nurse work schedules to enhance patient safety and prevent adverse outcomes, based on a systematic analysis of 22 studies from 2000 to 2019.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Relationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review. Bae, SH.[2021]

This study investigates how both alternative work schedules and nurses' preferred schedules impact their job satisfaction, perceived quality of patient care, and personal life balance.

By focusing on the combined effects of these schedules, the research aims to provide a more comprehensive understanding of how work arrangements affect nurses' overall well-being and professional performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Repercussions of work schedule congruence among full-time, part-time, and contingent nurses. Havlovic, SJ., Lau, DC., Pinfield, LT.[2019]

Implementing fixed scheduling for nursing staff in oncological inpatient care resulted in less overtime and fewer shift change requests, suggesting it may improve resource management.

However, the type of scheduling did not significantly impact patient-reported outcomes, indicating that while fixed scheduling may benefit staff, further research is needed to fully understand its effects on patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changed nursing scheduling for improved safety culture and working conditions - patients' and nurses' perspectives. Kullberg, A., Bergenmar, M., Sharp, L.[2018]

A year-long trial of a new nursing shift pattern (two 12-hour and two 6.25-hour shifts) received positive feedback from all 24 participating nurses and therapists, indicating high job satisfaction.

The new shift pattern was associated with a significant reduction in sickness rates and the use of agency nurses, suggesting improved health and wellbeing among staff.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modernising the 12-hour shift. Lea, A., Bloodworth, C.[2019]

A study comparing 8-hour and 12-hour nursing shifts across 10 wards found that 12-hour shifts resulted in significant reductions in direct patient care.

The increase in unofficial work-breaks during 12-hour shifts suggests that nurses may pace themselves to manage the longer hours, which could negatively impact patient care delivery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The quantity of nursing care on wards working 8- and 12-hour shifts. Reid, N., Robinson, G., Todd, C.[2019]

Shiftwork poses significant health risks for healthcare workers, especially as they age and accumulate more shiftwork experience, highlighting the need for well-designed work schedules that consider shift patterns and lengths.

Allowing healthcare workers to choose their shift systems and implementing strategies like self-scheduling and planned on-site napping can improve adaptation to shiftwork and enhance overall job satisfaction and performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shiftwork: what health care managers need to know. Kilpatrick, K., Lavoie-Tremblay, M.[2019]

In a study comparing health and performance outcomes among nurses, shift work was not found to be a significant risk factor for health issues or organizational outcomes, suggesting that factors like gender, age, and weight play a more crucial role.

Female nurses reported significantly more sleep disorders than their male counterparts, but those who were non-adaptive to shift work performed just as effectively and safely as their adaptive colleagues, indicating that adaptation to shift work may not be as critical for maintaining health and performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Shift work in nursing: is it really a risk factor for nurses' health and patients' safety? Admi, H., Tzischinsky, O., Epstein, R., et al.[2022]

Female nurses with school-aged children working three-day shift rotations face significant challenges in balancing their professional and parenting roles, leading to feelings of crisis and chaos in their lives.

To improve work-life balance for these nurses, it is essential for policymakers to implement supportive management practices, flexible work systems, and opportunities for professional development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child-rearing experiences of female nurses working three shifts in South Korea: A qualitative study. Yoo, HJ., Shim, J.[2022]

The study highlights the importance of innovative scheduling systems for nursing staff, emphasizing that flexibility in work schedules can significantly improve their quality of working life.

Utilizing change theory, the paper describes successful participative management approaches implemented by four nurse managers, which involved staff in the design and evaluation of new scheduling practices, leading to better engagement and responsibility among the nursing teams.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Planning change in scheduling practices: a theoretical perspective. Comack, M., Smith, SD., Bowman, A., et al.[2018]

Over 80% of nurses reported satisfaction with their scheduling, but longer shifts (over 13 hours) correlated with increased patient dissatisfaction with care.

Nurses working shifts of 10 hours or longer faced significantly higher rates of burnout and job dissatisfaction, suggesting that extended shifts can harm both nurse well-being and patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Stimpfel, AW., Sloane, DM., Aiken, LH.[2022]

Over 25% of surveyed nurses typically worked 12 or more hours per day, with more than a third working over 40 hours per week, indicating a prevalence of extended work schedules that could compromise nurse well-being and patient safety.

The study highlights that nearly 40% of nurses had on-call requirements, and a significant number experienced mandatory overtime, raising concerns about fatigue and health risks that could affect both nurses and the quality of patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How long and how much are nurses now working? Trinkoff, A., Geiger-Brown, J., Brady, B., et al.[2019]

A study classified 122 shift systems used by nurses and midwives in large hospitals in England and Wales, focusing on flexibility in rostering and rotation speed between night and day shifts, resulting in nine distinct categories.

The most prevalent shift system identified was a flexible day shift combined with a permanent night shift, highlighting the need for further research to determine which shift features minimize negative impacts on nurses' well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A classification of nursing and midwifery shift systems. Barton, J., Spelten, ER., Smith, LR., et al.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Relationships between comprehensive characteristics of nurse work schedules and adverse patient outcomes: A systematic literature review. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Repercussions of work schedule congruence among full-time, part-time, and contingent nurses. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Changed nursing scheduling for improved safety culture and working conditions - patients' and nurses' perspectives. [2018]

4. England pubmed.ncbi.nlm.nih.gov

Modernising the 12-hour shift. [2019]

5. England pubmed.ncbi.nlm.nih.gov

The quantity of nursing care on wards working 8- and 12-hour shifts. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Shiftwork: what health care managers need to know. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Shift work in nursing: is it really a risk factor for nurses' health and patients' safety? [2022]

8. England pubmed.ncbi.nlm.nih.gov

Child-rearing experiences of female nurses working three shifts in South Korea: A qualitative study. [2022]

9. Canada pubmed.ncbi.nlm.nih.gov

Planning change in scheduling practices: a theoretical perspective. [2018]

10. United States pubmed.ncbi.nlm.nih.gov

The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

How long and how much are nurses now working? [2019]

12. England pubmed.ncbi.nlm.nih.gov

A classification of nursing and midwifery shift systems. [2019]