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The Association Between Nurse Shift Patterns and Nurse-Nurse and Nurse-Physician Collaboration in Acute Care Hospital Units

Ma, Chenjuan, PhD; Stimpfel, Amy, Witkoski, PhD, RN

JONA: The Journal of Nursing Administration: June 2018 - Volume 48 - Issue 6 - p 335–341
doi: 10.1097/NNA.0000000000000624

OBJECTIVE The aim of this study was to examine the impact of nurse shift patterns on nurses' collaboration with nurses and physicians in US acute care hospital units.

BACKGROUND Collaboration between nurses and other healthcare providers is critical for ensuring quality patient care. Nurses perform collaboration during their shift work; thus, nurse shift patterns may influence collaboration. However, there is a dearth of empirical evidence of the relationship between nurse shift patterns and collaboration of nurses with other healthcare providers.

METHODS This is a cross-sectional study using data from 957 units in 168 acute care hospitals. Measures of collaboration include nurse-nurse collaboration and nurse-physician collaboration. Measures of shift patterns included shift length and overtime. Multilevel linear regressions were conducted at the unit level, controlling unit and hospital characteristics.

RESULTS Overtime (more nurses working overtime or longer overtime hours) was associated with lower collaboration at the unit level; however, shift length was not.

CONCLUSIONS Working overtime may negatively influence nurses' collaboration with other healthcare providers.

Author Affiliations: Assistant Professor (Dr Ma), Assistant Professor (Dr Stimpfel), Rory Meyers College of Nursing, New York University.

Funding was provided by Sigma Theta Tau International, Honor Society of Nursing (fund #10361).

The authors declare no conflicts of interest.

Correspondence: Dr Ma, Rory Meyers College of Nursing, New York University, 433 First Ave, NY 10010 (;

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.