title: Increased errors and decreased performance at night: A systematic review of the evidence concerning shift work and quality.
abstract: BACKGROUND
  Shift workers have worse health outcomes than employees who work standard business hours. However, it is unclear how this poorer health shift may be related to employee work productivity.
  
  
  OBJECTIVE
  The purpose of this systematic review is to assess the relationship between shift work and errors and performance.
  
  
  METHODS
  Searches of MEDLINE/PubMed, EBSCOhost, and CINAHL were conducted to identify articles that examined the relationship between shift work, errors, quality, productivity, and performance. All articles were assessed for study quality.
  
  
  RESULTS
  A total of 435 abstracts were screened with 13 meeting inclusion criteria. Eight studies were rated to be of strong, methodological quality. Nine studies demonstrated a positive relationship that night shift workers committed more errors and had decreased performance.
  
  
  CONCLUSIONS
  Night shift workers have worse health that may contribute to errors and decreased performance in the workplace.
authors.affiliation: Rutgers, The State University of New Jersey, Newark, NJ, USA.
authors.forename: Pamela B
authors.initials: PB
authors.lastname: de Cordova
authors.affiliation: Rutgers, The State University of New Jersey, Newark, NJ, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Bradford
authors.affiliation: Center for Health Policy, Columbia University School of Nursing, New York, NY, USA.
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
mesh_terms: D004526:Efficiency; D006801:Humans; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications* / Q000209:etiology; D014940:Work Schedule Tolerance / Q000523:psychology*
keywords: After-hours; efficiency; productivity; safety