Effective collaboration between health care professionals is essential for the delivery of high-quality patient care and good outcomes, but it has been suggested that the quality of interactions between hospital nurses and their colleagues can be adversely affected by long shifts and working overtime. To ascertain the association, researchers undertook an observational, cross-sectional study to examine the effects of nurses' shift patterns (shift length and overtime) on the quality of their collaboration with other nurses and physicians on acute care hospital units. Data from 957 units in 168 acute care hospitals across the United States were included in the analysis. Collaboration was measured using two six-item scales, one assessing nurse-nurse interaction and one assessing nurse-physician interaction. Higher scores on the six-point scales represented better collaboration.

Approximately 65% of units had shifts of 12 hours or more, 33% of nurses reported working overtime on their last shift, and 35% perceived an increase in management's demand that they work overtime. Shift length wasn't associated with collaboration, but overtime was. A one-hour increase in overtime was significantly associated with a 0.17-point decrease in the nurse-nurse collaboration score and marginally associated with a 0.13-point decrease in the nurse-physician collaboration score.

Providing appropriate shift schedules for nurses-in particular, minimizing overtime-may lead to improved collaboration among nurses and other health care providers, the authors suggest.-KR

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