title: Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study.
abstract: BACKGROUND
  Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics.
  
  
  OBJECTIVE
  To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model.
  
  
  METHODS
  This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design.
  
  
  METHODS
  The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration.
  
  
  METHODS
  Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated.
  
  
  RESULTS
  The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses working night shift were associated with a 16% [IRR 1.16, CI 1.02-1.33] increase in the risk of a sprain or strain injury.
  
  
  CONCLUSIONS
  Overtime and night shift work were significantly associated with increased injury risk in newly licensed nurses independent of other work factors and demographic characteristics. The findings warrant further study given the long-term consequences of these injuries, costs associated with treatment, and loss of worker productivity.
authors.affiliation: New York University College of Nursing, 433 First Avenue, 6th Floor, New York, NY 10010, USA. Electronic address: as8078@nyu.edu.
authors.forename: Amy Witkoski
authors.initials: AW
authors.lastname: Stimpfel
authors.affiliation: University at Buffalo School of Nursing, 210 Wende Hall, Buffalo, NY 14214-3079, USA. Electronic address: csbrewer@buffalo.edu.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Brewer
authors.affiliation: New York University College of Nursing, 433 First Avenue, 6th Floor, New York, NY 10010, USA. Electronic address: ctk1@nyu.edu.
authors.forename: Christine T
authors.initials: CT
authors.lastname: Kovner
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses; D060051:Occupational Injuries / Q000191:economics / Q000453:epidemiology*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D016012:Poisson Distribution
keywords: Nursing; Occupational health; Personnel staffing and scheduling; Risk