Professional Practice 

Occupational Injuries for Consecutive and Cumulative Shifts Among Hospital Registered Nurses and Patient Care Associates: A Case-Control Study

Karen Hopcia, ScD, ANP-BC; Jack Tigh Dennerlein, PhD; Dean Hashimoto, MD; Terry Orechia, MS; Glorian Sorensen, PhD, MPH

  • Workplace Health & Safety (formerly AAOHN Journal)
  • October 2012 - Volume 60 · Issue 10: 437-444
  • DOI: 10.3928/21650799-20120917-39


Nontraditional work shifts for hospital registered nurses and patient care associates and associated injuries were examined through a case-control study. Inpatient care requires that many staff work nontraditional shifts, including nights and 12-hour shifts, but some characteristics remain unexplored, especially consecutive shifts. A total of 502 cases (injured workers) were matched to single controls based on their hospital, unit type, job type, gender, and age (± 5 years). Conditional logistic regression was used for the analysis, controlling for weekly hours scheduled. For both, consecutive shifts of 2 or more days and some various cumulative shifts over a week and month period, especially night shifts, were associated with increased odds of injury. More investigations on the phenomenon of consecutive shifts are recommended. Additionally, the assessment of shift policy and subsequent injury outcomes is necessary before implementing intervention strategies.

Dr. Hopcia is Assistant Professor and Director, Occupational Health Nursing Program, Department of Health Systems Science, University of Illinois at Chicago, College of Nursing, Chicago, IL. Dr. Dennerlein is Professor, Bouvè College of Health Sciences, Department of Physical Therapy, Northeastern University, Boston, MA. Dr. Sorensen is Professor, Society, Human Development, and Health, Harvard School of Public Health, and Director, Dana Farber Cancer Institute Center for Community-Based Research, Boston, MA. Dr. Hashimoto is Chief of Occupational Medicine and Ms. Orechia is Senior Analyst, Partners Healthcare, Boston, MA.

This work was supported by a grant from the National Institute for Occupational Safety and Health (U19 OH008861) and in part by a grant from the National Cancer Institute (K05 CA108663) to Dr. Sorensen.

This study would not have been accomplished without the participation of Partners HealthCare System and leadership from Dennis Colling and Kurt Westerman. The authors thank Partners Occupational Health Services, including Marlene Freeley for her guidance; individuals at each of the hospitals, including Jeanette Ives Erickson, Mairead Hickey, Trish Gibbons, and Chris Graf in Patient Care Services leadership; and Jeff Davis and Lisa Pontin in Human Resources. They also thank Charlene Feilteau, Kate Myers, Mimi O’Connor, Margaret Shaw, Eddie Tan, and Shari Weingarten for assistance with supporting databases, and Christopher Kenwood from the New England Research Institute for statistical support.

Address correspondence to Karen Hopcia, ScD, ANP-BC, Assistant Professor and Director, Occupational Health Nursing Program, University of Illinois at Chicago, College of Nursing, Health Systems Science NURS 910, 845 S. Ashland Avenue, Chicago, IL 60612. E-mail:

Received: May 14, 2012
Accepted: August 09, 2012
Posted Online: September 24, 2012



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