Rough Draft Quantitative Research Critique and Ethical Considerations
Long working hours and shifts work are associated with increased cognitive errors in nursing practice. Both are believed to be occupational and safety hazard especially when concerning working practice. In most countries, one-third of the workforce has irregular working hours, and this affects the productivity of the workforce due to changing shifts. An article on “The impact of long work hours and shift work on cognitive errors in nurses” examines the relationship of long working hours and shifts and cognitive errors on nursing practice. Twelve-hour shifts are regularly used in hospitals, and there is a significant concern on the impact of long working hours on cognitive errors in nurses. Long working hours not only affect the nursing outcome but is associated with nursing demotivation and affects the well-being of nurses. Although long working hours are associated with poor patient outcome and decreased job satisfaction, there is need to understand better the effect of nursing shifts to nurses’ sleep and clinical decision making which are likely to impact on safe patient care. This particular research wanted to examine the impact of long working hours, and nursing shifts have on cognitive errors made during clinical decision making.
The research included twenty-eight nurses who worked on different shifts. Among the nurses were eight-hour shifts and twelve-hour shift. The selected nurses were assessed using actigraphy, after work questionnaire and sleep diary within their first consecutive shifts. The study was conducted in a 380-bed tertiary care hospital in Eastern Canada. All the participants of the study were requested to contact a trained research assistant so that they could be part of individual information and training session. The individual sessions allowed the researcher to collect data on sleep schedule and rest as well as the impact of long working hours on clinical decision-making. The study excluded nurses with a sleep disorder, those who were already taking medication as well as those who had medical conditions such as muscle spasm. The exclusion was to minimize bias and make the results of the study credible for use. Although the study had 30 participants initially, two of them were dropped due to a medical condition as required by the study.
The results of the study found out that nurses who were working for twelve-hour shift had less total sleep time as compared to those who worked on 8-hour day shifts. Therefore, less sleep efficiency was noted among nurses who worked on twelve-hour shifts. Also, twelve hour-shifts nurses napped more compared to their 8-hour shift counterpart. Nevertheless, no difference was noted among the two groups regarding the cognitive errors made during care. Therefore, nurses working for 12-hour shifts are likely to have irregular sleep patterns as compared to those working on 8-hour day shifts. Lack of adequate sleep not only affect patient outcome but can lead to adverse consequences on the health and well-being of the nurses.
The ultimate findings of the study revealed an effect of long working hours on sleep pattern, but there was no significant deviation was noted on errors made. The working shifts disrupt circadian rhythms that are essential in balancing internal body temperature, blood pressure, sleep patterns, and body’s hormone levels. When circadian rhythms are affected, they can interfere with normal body functions, thus lead to adverse health consequences. Sleepiness after awakening was also assessed and the study found out a higher probability for nurses working on 12-hour shifts as compared to those who worked for 8-hour shifts. 12-hour shift nurses reported being sleepier after waking and also after work, an indication that their sleeping pattern was irregular.
Uses of the Findings
The results can be used in nursing practice in various ways. Since the data was collected from credible sources and with the right quantitative methods, the findings of the study are credible for use in future studies that are interested in finding out the impact of long working hours on sleep pattern. Although some studies associated long working hours to increased nursing errors, this study has proved a lack of association between working hours and increased errors. Therefore, nurse managers should use the findings to protect nurses working for a 12-hour shift from any liability related to medical errors. Also, the managers can use the findings to understand the pressure associated with long working hours so that they can devise strategies to minimize working hours and change shifts. Also, they can use the findings to change in the work environment which can promote the nursing practice.
The findings can also be used to implement particular strategies related to greater shift work flexibility so that nurses working for 12-hour shifts can also work for an 8-hour shift. Flexibility is expected to impact positively on the sleeping patterns of nurses since there is a reduced effect of disturbed sleep patterns for nurses. Such strategies will protect nurses working for the 12-hour shift from adverse health effects and reduced motivation that can have a significant impact on the nursing outcome. The findings can assist in the implementation of strategies that will promote healthcare organizational changes in nursing practice. Although some nurses have fewer effects in sleep patterns even after working for long hours, the study revealed that majority of nurses’ sleep immediately after work and others have challenges after waking up due to disrupted sleeping patterns. And although the sleeping pattern does not contribute to medical errors, it has a significant impact on clinical decision making and nursing outcome.
The findings of this research can explain the reasons behind increased nurse fatigue and mental impairment among nurses working for 12-hour shifts. Irregular sleep schedules and adverse health outcomes can be associated with long working hours for nurses. Such an association impact nursing outcome, therefore, the findings can be used to implement policies and procedures that should guide nurses in the workplace on best practices to avoid nursing fatigue and to promote adequate sleep. With the findings, it can be assumed that twelve-hour shifts have negative effects on nurse’s sleep pattern and that ultimately affect the nursing outcome.
Ethical Considerations Associated with the Study
The study maintained ethics since it was approved by the ethics board of the participating institution. Besides, all participants signed a consent form before the study was started. The signing of consent is an indication that the participants were informed before they took part in the study. The research was conducted from a tertiary-care hospital in Eastern Canada and permission was sought from management before the research was conducted. The selection criteria used eliminated some cases increasing the credibility of the findings. Also, the nurses willingly participated in the study and the elimination criterion was well defined to minimize selection bias.
Conclusion
The research was well presented and the study outcomes well explained. The results of the study coincided with the literature review in that long working hours affect sleeping patterns and lead to adverse health effects. Therefore, the findings of this study can easily be generalized to other studies.