title: The effect of work hours on adverse events and errors in health care.
abstract: BACKGROUND
  We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.
  
  
  METHODS
  Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.
  
  
  RESULTS
  All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.
  
  
  CONCLUSIONS
  This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.
  
  
  CONCLUSIONS
  Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.
authors.affiliation: Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, USA. danielle.m.olds@gmail.com
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Olds
authors.forename: Sean P
authors.initials: SP
authors.lastname: Clarke
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000062:Accidents, Occupational / Q000706:statistics & numerical data; D000328:Adult; D003428:Cross Infection / Q000453:epidemiology*; D003695:Delivery of Health Care; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D016602:Needlestick Injuries / Q000453:epidemiology*; D009726:Nurses / Q000523:psychology* / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance; D016526:Workload