EXHIBIT 3.

Relationship Between Nurses’ Shift Length And Outcomes For Nurses

	Unadjusted		Fully adjusteda
Shift length, hours	OR	95% CI	OR	95% CI
BURNOUT
10–11	1.71	1.48, 1.97	1.58	1.35, 1.84
12–13	1.13	1.04, 1.22	1.11	1.02, 1.20
>13	2.85	2.47, 3.28	2.70	2.32, 3.15
JOB DISSATISFACTION
10–11	1.72	1.47, 2.02	1.67	1.40, 1.99
12–13	1.10	1.00, 1.20	1.12	1.03, 1.22
>13	2.42	2.09, 2.81	2.38	2.04, 2.79
INTENTION TO LEAVE EMPLOYER WITHIN A YEAR
10–11	1.49	1.21, 1.85	1.55	1.24, 1.95
12–13	1.53	1.37, 1.71	1.45	1.30, 1.63
>13	2.79	2.32, 3.35	2.57	2.10, 3.15

SOURCE Authors’ analysis of data from the Multi-State Nursing Care and Patient Safety Study (Note 17 in text), 2005–08.

NOTES The reference group is the shift category of 8–9 hours. Odds ratios (ORs) and confidence intervals (CIs) are derived from generalized estimated equation models that accounted for clustering of observations within hospitals. If both sides of the 95 percent confidence interval of the odds ratio are greater than 1, or both sides are less than 1, the result is considered significant

^aFully adjusted models account for nurse age, sex, type of unit, nurse staffing (see the text), professional practice environment (see the text), number of beds, and hospital teaching and technology status (see the text).