Nurses' sleep, work hours, and patient care quality, and safety.

Objectives: To describe sleep duration and work characteristics among registered nurses ("nurses") across health care settings and unit types and determine the association between sleep duration and quality of care and patient safety.

Design: We used an observational, retrospective design. Survey data were collected from two cohorts of nurses in 2015 and 2016.

Setting: Health care and community settings across the United States, primarily acute care hospitals.

Participants: Nurses working in a staff or general duty position (N=1,568).

Measurements: The independent variable was nurses' sleep duration before work and nonwork days. The two dependent variables were nurse reported quality of care (single item rating) and overall patient safety, measured by the Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture.

Results: Nurses reported an average of 414 minutes, or just less than 7 hours, of sleep before a work day and 497 minutes, or just over 8 hours, before a nonwork day. Short sleep duration was statistically significantly associated with lower ratings of quality of care (p=.002) and patient safety (p=.000).

Conclusions: Nurses are sleeping, on average, less than recommended amounts before work, which may be impacting their health and performance on the job. Health care managers may consider interventions to support nurses' sleep to improve patient care. Further research is warranted.