A Mixed-methods Systematic Review of Sleep Duration and Quality in Healthcare Workers: Impacts on Patient Safety and Quality of Care

ObjectivesThe aim of this systematic review was to synthesize evidence on the impacts of sleep duration and quality in healthcare workers on patient safety and quality of care. A secondary aim was to understand the impact of shiftwork and workload characteristics alongside sleep duration and quality.MethodsA systematic search of Scopus, PubMed, Embase, APA PsycINFO, and CINAHL databases was completed in May 2023 and updated in December 2024. Only studies published in English from 2013 onwards were considered for inclusion in the review. Quality appraisal of included studies was conducted via the McMaster tools for quantitative and qualitative studies, respectively, and results were synthesized and presented as a narrative summary.ResultsDatabase searching revealed 7,422 results, with 30 studies eventually included in the review. Studies consistently showed that short sleep duration in healthcare workers was associated with worse patient safety (increased errors and poorer cognitive functioning). There was also a clear link between shiftwork and long shifts with reduced patient safety.ConclusionsThe majority of included studies revealed that patient safety and quality of care are worse where HCWs experience short duration and/or low-quality sleep or are working long and/or irregular shifts.