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The Effect of an Educational Sleep Program on New Graduate Night Shift Nurses

The Effect of an Educational Sleep Program on New Graduate Night Shift Nurses. Ana-Maria Gallo, PhD., CNS., RNC-OB Director and Assistance Professor Kyle J. Page, A.B.D. South Dakota University

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The Effect of an Educational Sleep Program on New Graduate Night Shift Nurses

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  1. The Effect of an Educational Sleep Program on New Graduate Night Shift Nurses Ana-Maria Gallo, PhD., CNS., RNC-OB Director and Assistance Professor Kyle J. Page, A.B.D. South Dakota University Laurie Ecoff, PhD, MS, RN, NEA-BC; Caroline Etland, PhD, RN, CNS, AOCN, ACHPN; Kim Failla, MSN, RN, NE-BC; JaynelleStichler, DNSc, RN, FAAN, FACHE; Loralie Woods MSN, RN

  2. Thanks to the Generosity

  3. Background • The importance of sleep cannot be over stated. • The recommended 7-8 hours can be difficult to achieve, especially for nurses who work the night shift. • Sleep is essential for maintenance of good: • Health • Well-being • Fatigue results from inadequate sleep time or poor quality of sleep.

  4. Background Fatigue An overwhelming sense of tiredness, lack of energy and feeling of exhaustion associated with impaired physical and/or cognitive functioning. (Shen, Barbera & Shapiro, 2006)

  5. Caitlin Magliochetti, RN

  6. Effects of Sleep Fatigue Specific to Night Shift Nurses • Increased illness • Reduced alertness • Increased risk for work injury • Diminished response mechanism impairing performance and function

  7. Effects of Fatigue on Patient Safety • Slow reaction time • Lapses of attention to detail • Errors of omission • Compromised problem solving • Reduced motivation • Decreased energy for successfully completion of required task.

  8. Significance • New graduate nurse orientation programs are quite extensive • Orientation programs focus on: • Clinical skills • Competencies • Guidelines of care • Educational content does not include information on how best to prepare to work the night shift or what sleep behaviors should be followed to promote quality sleep.

  9. Purpose • The purpose of this study was to examine the effect of a cognitive intervention (sleep educational program) in new graduate night shift nurses.

  10. Study Design • A prospective, experimental, pre-survey and post-survey design was used to examine the effect of an educational sleep program on new graduate night nurses.

  11. Participant Inclusion Criteria Exclusion Criteria Experienced nurses new to Sharp HealthCare New nurses currently on nightshift New graduates hired to work days or flexed position. • Newly hired new graduates • Hired to work the night night • Sharp HealthCare facilities

  12. Setting Sharp Mary Birch Hospital for Women and Newborn Sharp Grossmont Hospital Sharp Chula Vista Medical Center Sharp Coronado Hospital Sharp Memorial Hospital Sharp Mesa Vista Hospital

  13. Data Collection Data collection periods • Prior to educational intervention • One month after the educational intervention

  14. Instruments • General Sleep Disturbance Scale (GSDS) • Pittsburgh Sleep Quality Index (PSQI) • Quality of Life Index • Fatigue Scale (VAS-F) • Sleep Diary Card • Sleep Log

  15. Sleep Educational Program • Knowles’ Theory of Adult Learning: • Understand sleep physiology, the sleep-wake cycle, and sleep architecture. • Discuss the effect of fatigue and sleep deprivation on patient safety. • Identify strategies for surviving the night shift with fatigue countermeasures.

  16. Data Analysis • Demographic data and diary cards were analyzed with descriptive statistics • A repeated measures ANOVA was run to compare within-group (i.e., pre-intervention and post-intervention, between-group (i.e., control and experimental), and the interaction of within-group and between-group comparisons. • SPSS version 25.0. • A power analysis conducted by the statistician recommended a sample size of 80 for a moderate affect.

  17. Results • Pre implementation 187 nurses participated • Experimental (n=84) • Control (n=102). • Post implementation 41 nurses completed the post survey • Experimental group (n=20) • Control group (n=21).

  18. Demographic Data

  19. Results PSQI Sleep Duration • No significant main effect for within-group or for between-group • Marginally significant interaction of within- and between-group

  20. Results PSQI Sleep Disturbances • No significant main effect for within-group or for between-group • Marginally significant interaction of within- and between-group

  21. Results PSQI Sleep Dysfunction • Significant within-group main effect • Marginal between-group main effect • Significant interaction of within- and between-group

  22. Results VAS-F Fatigue • Significant within-group main effect • Non-significant between-group main effect • Significant interaction of within- and between-group

  23. Discussion • It is crucial for nurses entering the profession to establish positive sleep hygiene habits to obtain the best sleep possible.  • The sleep educational program may have some effect on quality of sleep and fatigue, quality of life can be improved.

  24. Limitation • Small sample size • Retention rate = 22% • Timing from intervention to the start of first night shift.

  25. Implication into Practice • Health Care Worker Fatigue and Patient Safety: Sentinel Event Alert, Issue 48 • All staff should be educated on sleep hygiene and the effects of fatigue on patient safety. • Position Statements on Patient Safety, Healthy Nursing Work Hours and Fatigue • Adequate rest and recuperation between schedule work • Ongoing education concerning the impact of fatigue.

  26. Conclusion • Focus on sleep, sleep hygiene and fatigue management strategies are beneficial in assisting new graduates nurses manage their sleep to improve sleep patterns thus leading to optimal clinical performance and patient safety. • Nurses must take responsibility for managing their professional and personal lives to help diminish the effects of fatigue.  

  27. Questions? Thank you…

  28. References Admi, H., Tzischinsky, O., Espstein, R., Herer, P., Lavie, P., (2008) Shift work in nursing: Is it really a risk factor for nurse’s health and patient’s safety? Nursing Economics, 26 (4) 250-257. Berger, A.M., Hobbs, B.B., (2006) Impact of shift work on the health and safety of nurses and patients. Clinical Journal of Oncology Nursing, 10(4) 465-471. Chung, S.A., Wolf, T.K., Shapiro, C.M. (2009) Sleep and health consequences of shift work in women. Journal of Women’s Health, 18(7), 965-977. Keller, S.M. (2009) Effects of extended work shifts and shift work on patient safety, productivity, and employee health. AAOHN Journal, 57(12) 497-502. Shao, M-F., Chou, Y-C., Yeh, M-Y., Tzeng, W-C., (2010) Sleep quality and quality of life in female shift-working nurses. Journal of Advanced Nursing, 66(7) 1565-1572. Borgatti, J.C., (2008) Surviving the night shift. American Nurse Today, 3(10) 14-16. Fietz, I., Knoop, K., Glos, M., Holzhausen, M., Peter, J.G., Penzel, T. (2009) Effect of the first night shift period on sleep in young nurse students. European Journal of Applied Physiology, 107, 707-714. Peate, I. (2007) Strategies for coping with shift work. Nursing Standard 22(4), 42-45. West, S., Ahern, M., Byrnes, M., Kwanten, L., (2007) New graduate nurses adaptation to shift work: Can we help? Collegian, 14(1) 23-30.

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