Sickness absence and the organization of nursing care among hospital nurses.
OBJECTIVE
Primary nursing and team nursing are two different ways of organizing nurses' work in hospital wards. This study examined whether primary nursing is associated with lower sickness absence rates than team nursing is.


METHODS
Altogether 1213 nurses from 13 primary nursing wards and 13 team nursing wards participated in a 3-year observational study. The nurses' sickness absence records were linked with information on the organization of nursing in the wards.


RESULTS
After adjustment for demographic and ward characteristics, primary nursing, compared with team nursing, was associated with 26-42% higher annual rates of short (1-3 days) spells of sickness absence (P<0.05). The corresponding adjusted excess rates varied between 26% and 36% for the long (>3 days) absences, depending on the year (P<0.05). Among the primary and team nurses who had no sickness absence in the first year, primary nursing was associated with a 41% higher incidence of short-term sickness absence in the second year and a 56% higher incidence in the third year.


CONCLUSIONS
The expected benefits of primary nursing for nurses' health are not supported by data on recorded sickness absences. Recommendations to implement primary nursing in team nursing wards cannot be justified simply on the basis of potentially favorable effects on employee health.
Kivimäki
Mika
M
University of Helsinki and the Finnish Institute of Occupational Health, Helsinki, Finland. mika.kivimaki@ttl.fi
Mäkinen
Arja
A
Elovainio
Marko
M
Vahtera
Jussi
J
Virtanen
Marianna
M
Firth-Cozens
Jenny
J
D000328:Adult; D005260:Female; D005387:Finland; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009741:Nursing Staff, Hospital / Q000458:organization & administration*; D010348:Patient Care Team; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D016012:Poisson Distribution; D012044:Regression Analysis; D018582:Sick Leave / Q000706:statistics & numerical data*