In a recent study reported in the February 20, 2008 issue of JAMA,
Dr. Peberdy and Associates found that survival from cardiac arrests
was worse on nightshift and on weekends. Many previous studies have
also determined that other medical errors are higher at night and on
weekends as well. The author suggests some explanations for the
discrepancies such as differences in staffing levels, expertise of
personnel, and monitoring practices.

Given that staffing levels will probably always be less on nightshift
than on dayshift, the nurses working the nightshift need to have more
resources available to them to appropriately respond to emergency
situations. In addition, the nightshift often hosts the more junior
staff who may be lacking in their assessment skills. The researchers
did not suggest a specific mechanism causing the decrease in survival
but it is likely that a delay in assessing and/or treating the
cardiac arrest is what caused the poor outcomes.

Nightshift staff need training, mentors and additional resources so
that they can respond appropriately to emergency situations when
staffing is lacking.

From:
Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
arrest during nights and weekends. JAMA, 299; 785.

Best wishes,
David W. Woodruff, MSN, RN, CNS, CEN
President, Ed4Nurses, Inc.
www.Ed4Nurses.com