AN INTERVENTIONAL REPORT FOR PATIENT AND NURSE SAFETY
Summary
The study stipulated that the working hours far overstretched by nurses in the hospital are highly connected to errors. Weariness and lack of enough sleep by these nurses make them more prone to mistake. Fatigue countermeasures program is missing though many firms have devised ways to reduce errors and injuries that are associated with exhaustion.
Introduction
The purpose of the research was to assess the feasibility of fatigue countermeasures for nurses. It was to better the duration and quality of sleep amongst nurses and minimizing sleepiness during the day and hence less patient care errors. The variables under consideration were errors and drowsy driving, which were gauged among the 47 hospital staff nurses. It was before and after the implementation of the fatigue countermeasures for nurses. The null hypothesis stated in this study was the adoption of specifying fatigue intervention program employed in other countries will better the conscious of the nurses and hence reducing the patient care errors.
Literature review
The effect of long working hours by nurses on the safety of the patients has only been acknowledged lately. (Rahman, 2019).Working hours for nurses are of concern. Nurses should always be on their guard to attend to the needs of the patients. While on their watch, they should be able to recognize and identify any slight changes in the body of the patients and also to pinpoint any error that might be present due to medication. (Needleman, 2015).Many nurses on 12 hours shift are affected by the regular overtime, the problem of staying awake while on duty and lacking enough sleep. It leads to the making of errors while on the mission. These long working hours, combined with a lack of enough sleep by nurses, leads to mistakes. A nurse who had a short duration to sleep will always struggle to stay awake, and eventually, this is what contributes to a lot of errors as most of the nurses would fall asleep on their responsibilities.
Lack of enough sleep and long working hours causes driving impairment. Low sleep durations have been linked to depression and other psychiatric behaviors (Hirshkowitz, 2015). When depression sets in the faults would arise in a lot of things, the nurses affected would be tackling. The conditions will eventually cause a lot of errors. Risks associated with long working hours have been recognized in many industrial sectors. Many injuries and accidents in many industries are associated with fatigue among the employees. It is also discovered that high rate of divorce is contributed by long working hours. (Golden, 2002).
Extension of working hours do not allow for the recovery time, meaning dealing with many responsibilities at home will be a big problem. Many nurses forfeit their sleep to fulfill their professional duties. It will lead to exhaustion and sleep deprivation (Hwang, 2006).
Many industries and other professionals have come up with ways to curb errors associated with fatigue, but in the nursing profession, there have not been enough elaborate measures to alleviate the problem. Medical residency programs are championing for creation of awareness among nurses to sensitize on the issue of risk of fatigue. The problem is that no one has assessed the effectiveness of this type of fatigue countermeasures program for nurses.
Methodology
Pretest-posttest repeated measure was used in searching for assessment of fatigue countermeasures program for nurses as an attempt to getting involved in attenuating errors related to fatigue. Gathering of data was for two weeks before the intervention, and the final duration for data collection was done for twelve weeks after the intervention. The period for collecting data was chosen to analyze the assessment of implementing the fatigue countermeasures program for nurses.
The participants of this study were enrolled from medical-surgical units in three acute care Michigan hospitals. There were no biases in the selection of the units as all groups were equal in terms of size, patient’s acuity level, and the level of staffing. It was very imperative to ensure that someone has confidence in the data collected.T the nurses selected had to be working fulltime in each of the selected units. That is any nurse working thirty-six hours per week. The study only involved nurses as they were the focus group of this research. The sampling frame was obtained from the mailing list procured from human resource department. Consent forms were provided to the potential participants to fill in the demographic questionnaire. Those who consented were provided with additional forms to fill in. This saw sixty-two nurses agreeing to the same, and they were willing to participate in the research.
Majority of the participants were white women with a mean age of thirty-eight years. Quite a large number of nurses were found to be working on the twelve-hour shift.T here was no significant difference in the information gathered from all the participants who undertook the research.
The study used Pittsburg sleep quality index, Epworth sleepiness scale, and daily logbooks. Pittsburg sleep quality was used to calculate the quality of sleeping score in the globe. The most substantial score showed poor quality of sleep. Epworth sleepiness scale was used to calculate the seriousness of the sleepiness during the day. Logbooks were involved in gathering the information about the actual working hours assigned, difficulties in remaining awake while on duty, and the breaks they are given. The logbook had closed-ended questions where some spaces were left for the nurses to fill in their opinions concerning their working environment and their skill to instigate the fatigue countermeasures program for nurses. Pittsburg sleeps quality index, Epworth sleepiness scale, and daily logbooks comprised of study packet which was mailed to the nurse’s home and was given further instructions on how to answer the question. The participants were provided with a number they would if they experienced any difficulties in giving answers. All the participants were encouraged to finish and submit their study instruments. It was done through reminder postcards. All the nurses who involved in the process were each given five dollars per page for each completed logbook page. The study protocol was accredited by Institutional review board at Grand Valley State University.
Data analysis
The study employed the use of descriptive statistics to explain the demographic data, sleep measures, and variables related to working. The primary variable was changed in mean hours of sleep in the twenty-four-hour duration.
The analysis of variance technique and paired t-test was used to contrast the duration of sleep, quality of sleep, and daytime sleepiness. Chi-square tests were used to analyze occurrences of sleep on duty. A generalized estimating equation for repeated measures of categorical data was used to check on error reduction. The statistical level of significance was 0.05% in all the procedures involving statistics. Power analysis was also done using the methods established.
Results
Poor sleep quality was experienced among nurses with increased daytime sleepiness and reduced alertness at work or dealing with a motor vehicle. Sleep duration, sleep quality, attentiveness, and prevention of errors were highly improved after fatigue countermeasures program for nurses. The seriousness of daytime sleep was seen to be significantly reduced after the intervention. The nurses noted that there were some challenges. They felt a sense of guilt while engaging in activities of fatigue countermeasures program for nurses.
Conclusion
The preliminary findings are in support with the practicability of using fatigue countermeasures program for nurses for curbing fatigue among nurse, the betterment of sleep, and reduction of errors among nurses.
Recommendation
In future research, the suitability and effectiveness of the fatigue countermeasures program for nurses should be examined.
References
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Hirshkowitz, M., Whiton, K., Albert, S. M., Alessi, C., Bruni, O., DonCarlos, L., … & Neubauer, D. N. (2015). National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep health, 1(1), 40-43.
Rahman, S. A., Sullivan, J. P., Barger, L. K., Hilaire, M. A. S., Stone, K. L., O’Brien, C. S., … & Wright, K. P. (2019). 0969 Attentional Failures Are Correlated With Serious Medical Errors In Resident Physicians. Sleep, 42(Supplement_1), A390-A390.