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Guidelines for Reducing the Adverse Effects of Shift Work on Nursing Staff: A Systematic Review

Inchingolo AD, Inchingolo AM, Fatone MC, Ferrante L, Casamassima L, Trilli I, Inchingolo F, Palermo A et al.

Healthcare (Basel, Switzerland), 2025

8 citations

Abstract

Background: The increasing demand for care in hospital settings, often at a high intensity, requires organizing work according to 24 h shifts. Nevertheless, shift work (SW), especially at night, alters the circadian rhythm, negatively affecting the psychophysical health of nurses, compromising their quality of life, and jeopardizing patient safety. Shift-work-related diseases (SWDs) can arise from these disruptions.

Methods: This systematic review aims to evaluate the effects of several types of medical, psychotherapeutic, and educational interventions and strategies on shift-work-related diseases (SWDs). The databases PubMed, Embase, Web of Science, and Cochrane were searched using the MESH terms "shift work" and "nurses" from January 2015 to March 2025. A total of 43 articles were included in the final analysis.

Results: Quantitative findings from the studies showed, for example, improvements in sleep quality scores ranging from 15% to 40% with optimized shift planning, reductions in fatigue scores by 20-35% through strategic napping, and moderate effect sizes for light therapy interventions. Physical activity and relaxation techniques were associated with a 10-25% improvement in subjective well-being indices, while meal timing interventions led to reductions in gastrointestinal symptom prevalence by up to 18%. The selected articles were discussed by dividing them according to the type of intervention applied to shift nurses, namely improvement of shift planning, light and…

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