Night Shift

Safety and satisfaction are two incredibly important aspects that have become the focus of many nursing related studies. Actions to raise patient satisfaction and measures to increase patient safety have continuously been investigated and tested. Recently, with the help of evidence-based research, hospitals have begun to utilize shift reporting at the bedside and assessing patients’ needs every hour in a means to boost patient safety and satisfaction. It is my belief that with consistent implementation of bedside shift report and structured hourly rounding, nurses are able to maximize the safety of patients and their satisfaction with our care.

“Sleep Quality in Nurses: A Randomized Clinical Trial of Day and Night Shift Workers” is a quantitative study by Nui, Chu Chung, Lin, Chang, and Chou published in the journal of Biological Research for Nursing (2012). The article aims to compare the amount of recovery time needed by nurses that work the night shift in relation to nurses that work the day shift. In order to determine if a study is eligible to use for developing evidence based practice it is important to critique research articles (Lobiondo-Wood & Haber, 2014) for their quality and applicability. This will determine if the study is relevant and can be applied to nursing practice. That is the purpose of this paper.

With growing concern about patient safety and satisfaction, a change in where shift report is given has been a cause of concern. Traditionally, change-of-shift report is done at the nurses’ station or away from patients. Numerous studies have been conducted on moving the change-of-shift report from the nurses’ station or hallway to the patient’s bedside. An analysis of bedside shift reporting has revealed the benefits of increased patient satisfaction and safety as well as several challenges of implementation of bedside shift reporting.

This section tools? Provides an overview of the tools includes in this strategy included Blank incudes in this strategy Bed side Shift Report What is it how can help you get involved? information Inform the patient and family and family about the bedside shift report is and how they can take part is and how they can take Give to patient on the day of admission, this handbook explains what bedside shift report is, during bedside shift report • Ferment 1-page handout Tool 3 Nurse Format: Bedside Shift Report Training prepare nurses to conduct nurses shift report. Slides and “talking points to train nurses to conduct a bedside

In order to incorporate the inter-shift report change to bedside shift report, the hospital’s unit leadership, specifically the clinical nurse leader as well as the nurse manager, will play a major role in incorporating bedside shift report. Also, a specific focus committee needs to be formed, involving the director of professional development and education, nursing stuff, the director of nursing, nursing leader and manager. The committee will make a plan of how to make this change as smooth as possible. The benefits of doing so are improved communication between RN’s and other healthcare professionals about the patient’s health care plan, patients will be informed about care and who is caring for them, which in the end will lead to safer care

A considerable amount of literature has been published on the impact of working hours (8 vs. 12 hour shifts) on fatigue among the nurses. These studies revealed that twelve-hour shifts increase the risk of fatigue, reduce the level of alertness and performance, and therefore reduce the safety aspect compared to eight-hour shifts (Mitchell and Williamson, 1997; Dorrian et al., 2006; Dembe et al., 2009; Tasto et al., 1978). Mills et al. (1982) found that the risk of fatigues and performance errors are associated with the 12-hour shifts. Beside this, Jostone et al. (2002) revealed that nurses who are working for long hours

With regard to sleepiness, several studies indicated that the average of sleep duration in 1910 to 2002 have decreased from 9 to 6 hours on workdays (National sleep foundation, 2002; Groger et al., 2004). Recently, a survey study of Roger et al. (2004) shows that an American Nurses have an average of 84 minutes more sleep on non workdays. Thus, shift work suggested as a cause of sleeping disorder among nurses where they feel of sleep during the shift. Considering the contributing factors of sleepiness, the literature identified that long working hours and rotating shifts are causing sleeping disorder. In the night and rotating shifts, the nurses are rarely obtained adequate amount of sleep. In fact, the nurses experiencing less sleeping hours (1 to 4 hour) than normal sleeping (Zeisler et al.,1980). Nevertheless, insufficient sleep is a significant reason of damaging planning, decision-making, and integration of information (Krueger, 1994; Harrison and Horne, 2000). More recent studies have revealed that long hour shifts and overtime are strongly linked to the difficulties of being a wake through the shift which leads to increase the risk of making an error (Scott et al., 2006; Roger et al., 2004).

Evidence also supports that bedside shift reporting is financially beneficial for staff nurses and nursing management. The average report time is significantly decreased from an average of 45 minutes to 29 minutes (Gregory, et al., 2014). This reduces overtime and saves hospitals money. Nurses’ satisfaction is improved because they get to end their shift on time. They get to proceed with shift report more quickly, with fewer distractions and in real time (when compared with writing or recording report). Increase in nursing satisfaction reduces turn over and, once again, saves hospitals money (Gregory, et al., 2014).

End of shift reports in this unit are often taken place at the central nursing station, at nurses’ lunch room, or at the medicine room. Although JCAHO has defined bedside shift report as one of the strategies to encroach patient satisfaction (Guide to Patient and Family Engagement in Hospital Quality and Safety, 2013), many nurses are still reluctant to this methods for many reasons. It seems as the cynicism of the implementation is still exceedingly high. Many argue that the implementation is non-beneficial and outweigh the cost. These include the longer time they spend in the report, the unavailability of the patient (e.g. confused, comatose patient), the confidentiality and privacy (e.g. visitors in the room), nervousness in front of the

Fatigue is defined as a feeling of tiredness or exhaustion or a need to rest because of lack of energy or strength. Fatigue in nurses directly affects the quality of care that the nurse gives to a patient. Nurse fatigue can be described as fatigue affecting the nurse population that may result from the following contributing factors: working long shifts in the healthcare workplace; obtaining insufficient sleep between scheduled shifts; a disturbance in circadian rhythms; and attempting to balance demanding personal, familial, and social obligations in addition to the work schedule. This article explains the implications of nursing fatigue.

Health care professionals are need all day long that’s why this in this profession people world rotating shifts. Those shifts are usually 6-14, 14-22 and 22-6 am. So we are seeing 3 different patterns in rotating shift which means that we are also seeing 3 rotating on sleeping patterns.

“Sleeping while on duty” or “sleeping on the job” are terms that describe a worker falling asleep while working at an occupation (Fallis, McMillan, & Edwards, 2011). In the United States certain higher risk jobs involving security, safety, or health of others (such as nursing), the penalty for being caught sleeping on the job can range from disciplinary action to immediate termination of employment (Fallis, McMillan, & Edwards, 2011).

Limited attention has been paid to the hours worked by nurses, or the effects of these hours on patient safety (Rogers, 2008). Even though most nurses favor 12- hour shifts and overtime, it is associated with difficulties staying awake during times of duty, reduced sleep times, and triple the risk of making an error (Rogers, 2008). The most significant risk of making an error occurred when nurses were scheduled to work 12.5 hours or more.

The term ‘Shift work’ is usually referred to uniformly divided allocations of the day in which individuals participate alternatively to provide twenty four hour coverage. A shift in sleep schedule conflicts with the body’s natural clock also known as the circadian rhythm into interpreting the time as ‘inappropriate’ and disrupts the homeostatic regulation cycle resulting in poor health outcomes. Fortunately, it is deemed possible to counter unfavourable effects of alternating insomnia and sleepiness through certain practices.

What do people think of when they first hear the word nap? Everyday sayings such as snatching a nap, being caught napping, snoozing, or stealing forty winks are all beneficial daily activities we need to add to our busy life. If we do, we will be more awake and capable to reach our full potential as an individual. People don’t realize how important a nap can be. Although popular beliefs suggest that naps are a waste of time, naps actually increase productivity by resting the brain.