Nurses' Extended Work Hours and Patient, Nurse, and Organizational Outcomes in General Hospitals, Thailand

Nursing shortage has affected the increasing of nurse workloads which may impact working error as well as patient, nurse, and organizational outcomes. The purpose of this study was to describe nurses' extended work hours and to examine the relationship between nurses’ extended work hours and patient, nurse, and organizational outcomes in general hospitals, Thailand. The sample included 506 nurses who have worked more than 40 hours per week in 24 general hospitals, Thailand. The research instruments consisted of 5 parts as follows: a demographic form; the Nurses’ Extended Work Hours Form; the Patient, Nurse, Organizational Outcomes Form; the Organizational Productivity Questionnaire; and the Maslach Burnout Inventory. The reliabilities of the Organizational Productivity Questionnaire and the Maslach Burnout Inventory were .95 and .82, .71, and .84 for emotional exhaustion, depersonalization, and personal accomplishment, respectively. Data were analyzed using descriptive statistics and spearman correlation. The results of study showed that, on average, the sample worked 58.74 hours per week (SD=12.33). About 80.33 percent of the sample had the chance of working two continuous shifts. The emotional exhaustion and depersonalization were at a high level (= 30.37, 10.08), while personal accomplishment was at a low level (= 45.30). It indicated high burnout among the sample. Extended work hours were positively related to patient identification error, the occurrence of pressure ulcer, patient complaints, emotional exhaustion, and depersonalization (r= 0.145, p= .001; r=0.150, p= .001; r=0.103, p=.026; r=0.097, p=.029; r=0.105, p=.018, respectively). Nurses’ extended work hours were negatively related to nurses’ health condition during the first year of working, nurses’ health condition after the first year of working, adequacy of rest and sleeping, the balance between work and life (r= -0.087, p=.050; r=-0.114, p= .010; r=-0.155, p=.000; r=-0.125, p=.005, respectively). Nurse managers can apply the results of this study as evidence to improve nurse workforce and human resource policy.