Approach to Scheduling in Nursing Assignment

Approach to Scheduling in Nursing Assignment

This paper is aimed at discussing the fatigue experienced by nurses who work a 12-hour shift three days per week. It results in burnout and job dissatisfaction. Moreover, this issue can considerably impair the quality of care. Very often, medical workers may not pay due attention to the needs of patients, and they can commit serious errors. In turn, the transition to an 8-hour shift five days a week can significantly reduce the nurses’ fatigue. This assumption is supported by existing evidence (Chen, Davis, Daraiseh, Pan, & Davis, 2014, p. 596). In turn, the primary objective is to alter the working schedule of nurses. Moreover, one should evaluate the outcomes of this intervention and disseminate findings to other stakeholders.

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Change Model Overview

It is possible to apply such a tool as John Hopkins Nursing Evidence-Based Practice Process. This model includes several steps. At first, one should define a practice question related to the delivery of medical services (Melnyk & Fineout-Overholt, 2011, p. 271). Additionally, medical workers should examine various types of evidence that can illustrate the origins of a problem and the ways in which it can be overcome. Finally, it is critical to translate this knowledge into practical applications.

Practice Question

Step 1: Recruit Inter-professional Team

The project will require the participation of different professionals such as the charge nurse, the financial manager, and three registered nurses who are skilled in conducting surveys and analyzing data. Among stakeholders, one can distinguish medical workers, patients, and hospital administrators.

Step 2: Develop and Refine the EBP Question

One should determine if the transition to an eight-hour shift can decrease the level of nurses’ fatigue. Much attention should be paid to the PICO (Population, Intervention, Comparison, and Outcome) elements. The population includes nurses working in various clinics and hospitals. In turn, the intervention is the adoption of an eight-hour shift five days per week. One should compare this approach with the current 12-hour shift three days per week. This policy should achieve several outcomes. In particular, it should decrease the level of nurses’ fatigue and improve the quality of care in medical organizations.

Step 3: Define the Scope of the EBP

The crucial problem is that nurses, who work for 12 hours during three consecutive days, cannot overcome fatigue. This problem contributes to the increased turnover in medical organizations. Moreover, this situation can result in medical errors and patients’ dissatisfaction. According to research findings, at least 80 percent of nurses report high levels of fatigue caused by 12-hour shifts. Moreover, they cannot recover their strength (Chen et al., 2014). Finally, the longer duration of working shifts in medical organizations increases patients’ dissatisfaction with the quality of services (Stimpfel, Sloane, & Aiken, 2012, p. 2501).

Steps4 and 5: Determine Responsibility of Team Members

The charge nurse will have to develop a new schedule for other medical workers. This professional should ensure that the medical organization is adequately staffed. Furthermore, one should consider the role of the financial manager. This person will estimate the costs of the project. Moreover, this worker should identify the budgetary limits that must not be exceeded. Finally, registered nurses, who will be recruited for this project, will interview medical workers as well patients. They will collect the evidence that can show if this intervention has been efficient.


Steps 6 and 7: Conduct Internal/External Search for Evidence and Appraisal of Evidence

The search of evidence included the identification of relevant peer-reviewed articles that can cast a light on the problem of nurses’ fatigue. It was necessary to focus on those studies that explored various approaches to scheduling. These research articles present the results of surveys carried out in different medical institutions. The information included in these sources was collected in many countries (Griffiths et al., 2014). In each of the studies, the independent variable was the duration of the working shift. In turn, the dependent variables included the level of nurses’ fatigue and patients’ satisfaction. The major strength of the chosen sources is that researchers gather information in various settings. Moreover, the samples of the selected studies are very large. Thus, the findings of the authors can be generalized.

Steps 8 and 9: Summarize the Evidence

The findings of researchers indicate that nurses, who work an eight-hour shift five days per week, are less likely to experience fatigue (Stimpfel et al., 2012). They also argue that the adoption of the 12-hour shift is associated with the dissatisfaction of patients (Griffiths et al., 2014). Moreover, their findings suggest that longer hours can contribute to the increased mortality in medical organizations (Trinkoff et al., 2011). Moreover, it is extremely difficult for nurses to overcome this exhaustion (Chen et al., 2014).

Step 10: Develop Recommendations for Change Based on Evidence

Overall, one can suggest that this hospital should adopt the eight-hour shift for nurses.


Steps 11, 12, and 13, 14: Action Plan

This plan will include several steps. At first, one should secure the support of hospital administrators. The team should inform them about the benefits of this policy. Secondly, one should develop a new schedule for medical workers. It is also necessary to inform nurses about the new policy. This project should be implemented within six weeks. Much attention will be paid to the follow-up assessment. This goal can be achieved by surveying nurses and patients. Medical workers should tell if this change enables them to cope with fatigue. In turn, patients should rate the quality of services that were provided to them. The policy should be implemented in one unit of this hospital. In contrast, other nurses will work a 12-hour shift. This approach is helpful for comparing the efficiency of two scheduling methods. The results should be presented in the form of a written report. It should be distributed to hospital administrators. Furthermore, this document should be available online.

Steps 16 and 16: Evaluating Outcomes and Reporting Outcomes

The outcomes of this intervention should be assessed according to several criteria. In particular, one should focus on the level of nurses’ fatigue and their burnout. For instance, it is possible to apply such a tool as the Maslach Burnout Inventory (Sloan, 2006, p. 21). Additionally, one should use the questionnaire that can determine if patients are satisfied with medical services.

Steps 17: Identify Next Steps

To promote the adoption of this policy, one should lay stress on the positive impacts of the new policy. Furthermore, this approach to scheduling should be adopted in various units of this hospital. One can argue that this method can be adopted in many settings.

Step 18: Disseminate Findings

The result should be presented in the form of a written report. One should send it to hospital administrators and charge nurses working in various departments. Furthermore, it is possible to make a presentation to explain the benefits of the new policy. Additionally, the findings will be accessible on the Internet so that other medical workers can learn about this intervention.


The 12-hour shift can lead to nurses’ fatigue and impair their performance. The review of existing evidence suggests that the use of the eight-hour shift can reduce this exhaustion and improve the quality of care. This report describes how this intervention can be implemented in one unit of a medical organization.

Reference List

Chen, J., David, K., Daraiseh, N. Pan, W., & Davis, L. (2014). Fatigue and recovery in 12-hour dayshift hospital nurses. Journal of Nursing Management, 22(5), 593-603.

Griffiths, P., Dall’Ora, C., Simon, M., Ball, J., Lindqvist, R., Rafferty, A. M.,… & Aiken, L. H. (2014). Nurses’ shift length and overtime working in 12 European countries: The association with perceived quality of care and patient safety. Medical Care52(11), 975-981.

Melnyk, B., & Fineout-Overholt, E. (2011).John Hopkins Nursing Evidence-Based Practice Process. New York, NY: Lippincott Williams & Wilkins.

Sloan, G. (2006).Clinical Supervision in Mental Health Nursing. New York, NY: John Wiley & Sons.

Stimpfel, A., Sloane, D., & Aiken, L. (2012). The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs31(11), 2501-2509.

Trinkoff, A., Johantgen, M., Storr, C., Gurses, A., Liang, Y., & Han, K. (2011). Nurses’ work schedule characteristics, nurse staffing, and patient mortality. Nursing Research60(1), 1-8.

Approach to Scheduling in Nursing Assignment

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