Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study

Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross-sectional survey

AIMS

This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS).

DESIGN

A nationwide cross-sectional survey was conducted.

METHODS

Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors.

RESULTS

A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs.

CONCLUSION

The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere.

NO PATIENT OR PUBLIC CONTRIBUTION

Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.

Alterations of functional brain activity and connectivity in female nurses working on long-term shift

AIM

To investigate the alterations of functional brain activity and connectivity in female nurses working on long-term shifts and explore their correlations with work-related psychological traits.

DESIGN

An exploratory cross-sectional study.

METHODS

Thirty-five female nurses working on long-term shifts (shift nurses) and 35 female nurses working on fixed days (fixed nurses) were enrolled. After assessing the work-related psychological traits, including burnout, perceived stress, anxiety, and depression of nurses, the fractional amplitude of low-frequency fluctuations (fALFF) and region of interest (ROI)-based functional connectivity (FC) analyses were performed to investigate the differences of brain spontaneous activity and functional connectivity between these two groups of nurses. Thereafter, correlations between the functional brain parameters (fALFF and FC) and clinical metrics were investigated among the shift nurses.

RESULTS

Compared to fixed nurses, shift nurses had higher burnout, perceived stress and depression scores, lower fALFF in the right dorsolateral prefrontal cortex (dlPFC), left and right superior parietal lobule (SPL), bilateral anterior cingulate cortex (ACC), and higher fALFF in the right superior/middle temporal gyrus, as well as decreased FC between the right dlPFC (the selected ROI) and bilateral ACC, left and right inferior frontal/orbitofrontal gyrus (IFG/IOFG), right SPL, and left middle occipital gyrus (voxel-level p < 0.001, cluster level p < 0.05, GRF correction). Correlation analyses demonstrated that the fALFF value of the right dlPFC was significantly correlated with the burnout and anxiety scores, the FC value of the right dlPFC-right SPL was correlated with the perceived stress and burnout scores, the FC value of the right dlPFC-right IFG/IOFG was correlated with the burnout score in shift nurses (p < 0.05).

CONCLUSION

Shift nurses had work-related altered functional activity and connectivity in the right frontoparietal network, which provided objective and visualised evidence to clarify the hazards of long-term shift work on female nurses.

PATIENT OR PUBLIC CONTRIBUTION

Seventy nurses participated deeply as subjects in this study. These findings are expected to draw managers' attention to the harmful influences of shift work on nurses.

Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators

BACKGROUND

9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators' stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours-mandatory and voluntary-and the level of stress symptoms among 9-1-1 telecommunicators.

METHODS

We used secondary data from the surveys of the "Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1" study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level.

RESULTS

Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 (SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 (SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = -0.01, p = .885).

CONCLUSION/APPLICATION TO PRACTICE

Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.

Associations between maternal occupational exposures and pregnancy outcomes among Chinese nurses: a nationwide study

BACKGROUND

Several studies have provided evidence about adverse pregnancy outcomes of nurses involved in occupational exposure. However, the pregnancy outcomes among nurses in middle-income countries are not well demonstrated. The main aim of this study is to present the prevalence and influencing factors of pregnancy outcomes among female nurses in China.

METHODS

We included 2243 non-nurse health care workers, and 4230 nurses in this national cross-sectional study in China. Information on occupational exposures and pregnancy outcomes was collected using a face-to-face investigation. Odds ratios (ORs) were estimated through logistic regression.

RESULTS

The proportion of threatened abortion, spontaneous abortion, and stillbirth of female nurses was 2.6%, 7%, and 2.1%, respectively. We found an increased risk of threatened abortion among nurses with overtime work (OR = 1.719, 95% CI 1.158-2.550). The risk of threatened abortion and spontaneous abortion was elevated among nurses handling disinfectant (OR = 2.293 and 1.63, respectively). We found a nearly twofold increased risk of premature birth (OR = 2.169, 95% CI 1.36-3.459) among nurses handling anti-cancer drugs.

CONCLUSIONS

Our findings suggested that maternal occupational exposures might be associated with the risk of adverse pregnancy outcomes among female nurses in China. We recommend that policy-markers and hospital managers work together to reduce exposure to occupational hazards and improve pregnancy outcomes among female nurses.

Shift work organization on nurse injuries: A scoping review

BACKGROUND

Extended work hours and shift work can result in mistimed sleep, excessive sleepiness, and fatigue, which affects concentration and cognition. Impaired concentration and cognition negatively affect employee safety.

OBJECTIVE

To examine the evidence of the impact of shift work organization, specifically work hours and scheduling, on nurse injuries including needlestick and sharps injuries, drowsy driving and motor vehicle crashes, and work-related accidents causing a near miss or actual injury to the nurse.

METHODS

A scoping review was conducted using search results from five bibliographic databases.

RESULTS

Through database searching, 7788 articles were identified. During the title and abstract screening, 5475 articles were excluded. Full text screening eliminated 1971 articles. During the data extraction phase, 206 articles were excluded leaving 34 articles from 14 countries in the scoping review. The results of the review suggest a strong association in nurses between long work hours and overtime and an increased risk for needlestick and sharps injuries, drowsy driving and motor vehicle crashes, and other work-related accidents. Rotating shifts increase the risk for needlestick and sharps injuries and other work-related accidents while night and rotating shifts increase the risk for drowsy driving and motor vehicle crashes.

CONCLUSIONS

Proper management of work hours and scheduling is essential to maximize recovery time and reduce or prevent nurse injuries. Nurse leaders, administrators, and managers, have a responsibility to create a culture of safety. This begins with safe scheduling practices, closely monitoring for near miss and actual nurse injuries, and implementing evidence-based practice strategies to reduce these occurrences.

Investigating factors that reduce burnout among newly licensed registered nurses

BACKGROUND: Burnout among newly licensed registered nurses is a prevalent healthcare issue. OBJECTIVE: To investigate the factors that reduce nurse burnout: workload, job interference with home life, having friendly co-workers, and inspirational motivation. METHODS: Secondary data from Kovner et al.’s 2006–2015 longitudinal survey was used to conduct a factor analysis. Kovner et al. surveyed 1,706 newly licensed nurses who received their nursing licenses in 2002 in the United States. The factor analysis identified the relationships between several questions about burnout symptoms and organizational factors. RESULTS: Supervisors inspiring the best in their employees, job satisfaction, and nurses’ job expectations matching their actual job duties were found to be related. Heavy workloads, nervousness, mood swings, irritability, and feeling on edge were also related. Additionally, job’s interference with home life and friendly co-workers were unrelated. CONCLUSIONS: Burnout can be mitigated by lessening workloads, supporting nurses, and ensuring nurses’ job expectations are met. Further research is needed to explain why some factors, such as having friendly co-workers, did not appear to influence burnout symptoms.

Experiences and perceptions of nurses working night shift: a qualitative systematic review

OBJECTIVE

The objective of this review was to examine the available evidence on the experiences and perceptions of nurses working the night shift within any specialty in the acute care, subacute, or long-term care setting.

INTRODUCTION

Nurses are required for around-the-clock patient care. Night shift nurses can experience detrimental effects because of their work hours, which disrupt their normal circadian rhythm. Understanding nurses' experiences and perceptions when working night shift will facilitate the development of strategies to minimize the potential negative effects of working at night. In examining nurses' experiences and perceptions of working night shift, there is scope to explore how to improve night shift nurses' practice environment and job satisfaction, which will then translate to improved nurse and patient outcomes.

INCLUSION CRITERIA

This review included qualitative studies focused on the experiences and perceptions of registered nurses and licensed practical nurses who work the night shift or rotate between day and night shift.

METHODS

This review followed the JBI methodology for systematic reviews of qualitative evidence. The methodology used was consistent with the a priori protocol. Studies included in this review were those published in full text, English, and between 1983 (when the seminal work on hospitals that attract and retain nurses was published) and February 2021, when the search was completed. The main databases searched for published and unpublished studies included MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science.From the search, two reviewers independently screened the studies against the inclusion criteria, and then papers selected for inclusion were assessed for methodological quality. Qualitative data were extracted from the included papers independently by the four reviewers. Results from each reviewer were discussed and clarified to reach agreement. The extracted findings were pooled and examined for shared meaning, coded, and grouped into categories. Common categories were grouped into meta-synthesis to produce a comprehensive set of synthesized findings. The final synthesized findings were graded using the ConQual approach to determine the level of confidence (trust) users may have in the value of the synthesized findings.

RESULTS

Thirty-four papers, representing 33 studies, met the criteria for inclusion. The studies were conducted in 11 countries across six continents, with a total of 601 participants. From these, a total of 220 findings were extracted and combined to form 11 categories based on similarity in meaning, and three syntheses were derived: i) The "Other" Shift: the distinctiveness of night nursing; ii) Juggling sleep and all aspects of life when working nights; and iii) Existing in the Twilight Zone: battling the negative impact of sleep deprivation consumes nurses who strive to keep patients, self, and others safe.

CONCLUSIONS

The major conclusions from this review are the uniqueness of working the night shift and the sleep deprivation of night nurses. Organizational strategies and support are needed for those working this shift, which will enhance nurse and patient safety.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO CRD42019135294.

A systematic literature review on the utilization of extended operating room hours to reduce surgical backlogs

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'.

Introduction

Hospital managers address elective patient surgical backlogs with different strategies: increasing installed capacity, managing demand and improving efficiency. Recently, and particularly since the COVID-19 elective surgery suspension, extended operating room hours has been used to reduce waiting lists by taking advantage of empty operating rooms and existing surgical teams.

Methods

Two research questions are raised: (1) which are the scientific literature's insights related to the use of extended operating room hours to help reduce surgery backlogs? and (2) provided that a hospital decides to extend its operating room opening time, what are the main challenges and the key aspects to consider in the design and implementation of policies to manage extended operating room hours? A systematic review on Web of Science database was conducted to gather existing literature, published from January 2012 to December 2021, regarding strategies to reduce waiting lists using empty operating rooms outside regular working hours.

Results

A total of 12 papers were selected as relevant to address the two research questions. Results were organized according to their main features, namely setting, type of strategy, methodology, and how human resources are handled.

Discussion

The review suggests that extended operating room hours might be problematic if current staff is used and that a careful choice of patients should be made. However, its potential to reduce waiting times and its implications are discussed only superficially. Therefore, we analyze the implications of extending operating room hours from four different perspectives (management, staff, patients, and strategy deployment) and define some recommendations for policy makers and healthcare managers when implementing it in practice.

Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China

AIMS

This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses.

BACKGROUND

Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet.

METHOD

A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported.

RESULTS

Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect.

CONCLUSIONS

Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China.

IMPLICATIONS FOR NURSING MANAGEMENT

Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.

Experiences, Perceptions, and Coping Patterns of Emergency Department Nurses with Occupational Stressors in Saudi Arabian Hospitals: Mixed-Method Study

Extended working hours, a complicated workplace environment, and engagement in numerous physical and psychological stressors have been associated with the stressful nature of the nursing profession. Only a few studies have provided some insight into workplace stress and coping strategies adopted by nurses in Saudi Arabia and neighboring countries. Therefore, this study utilized a mixed-method design to explore the numerous factors that lead to stress among emergency nurses, their experience and perception of stress, and the coping mechanisms they find useful. A survey containing four domains and 86 items was adapted, pilot tested, and validated. The quantitative phase recruited 296 nurses who returned completed questionnaires, and then 21 nurses were interviewed for the qualitative phase. In total, 89.5% (n = 265) of the participants were female, 51% (n = 151) were aged 20–29 years, 83% (n = 246) were non-Saudi nationals, 49% (n = 145) were married, and 82% (n = 245) had a bachelor’s degree. The most common causes of occupational stress were work overload, personnel shortages, and inadequate pay. The qualitative phase data revealed five primary themes, including increased workload, rising living costs despite equal compensation, and staff shortages as main stressors. In addition, the study found that praying and spending quality time with friends are the primary coping techniques among nurses. The study results contribute to a better understanding of nurses’ working conditions in the emergency department. Additionally, they may contribute to the development of policies and practice reforms to improve Saudi nurses’ well-being, health, and overall work experience.

A shift to something better? A longitudinal study of work schedule and prescribed sleep medication use in nurses

OBJECTIVES

To explore whether a change in work schedule was associated with a change in the probability of prescribed sleep medication use.

METHODS

A longitudinal study with annual questionnaire data (2008/2009-2021, except 2019) on work schedule (day work only, shift work without nights and shift work with nights) and prescribed sleep medication use from 2028 Norwegian nurses (mean age 31.7 years, 90.5% women at baseline) who participated in the ongoing Survey of Shift work, Sleep and Health (SUSSH). Associations were estimated using a random effects model, and a fixed effects regression model in which nurses were included as their own control to account for potential unobserved confounding.

RESULTS

In both models, day work was associated with a more than 50% lower probability of sleep medication use compared with shift work with nights (adjusted OR (aOR) 0.50, 95% CI 0.27 to 0.93 in the random effects model, and an aOR 0.32, 95% CI 0.14 to 0.70 in the fixed effects regression model). Shift work without nights was associated with a non-statistically significant reduction in sleep medication use within nurses in the fixed effects regression model when compared with shift work with nights (aOR 0.66, 95% CI 0.37 to 1.20).

CONCLUSIONS

Day work was associated with a significant reduced probability of prescribed sleep medication use compared with shift work with nights. This indicates that quitting night work will improve sleep and thereby reduce hypnotic use.

Meta-analysis of nursing-related organizational and psychosocial predictors of sickness absence

BACKGROUND

Nursing is a stressful occupation with high rates of sickness absence. To date, there are no meta-analyses that statistically determined the correlates of sickness absence in this population.

AIMS

This meta-analysis examined organizational and psychosocial predictors of sickness absence among nursing staff.

METHODS

As a registered systematic review (PROSPERO: CRD42017071040), which followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, five databases (CINAHL, PROQuest Allied, PROQuest database theses, PsycINFO, PubMed) were reviewed to examine predictors of sickness absence in nurses and nursing assistants between 1990 and 2019. The Population/Intervention/Comparison/Outcome tool was used to support our searches. Effect sizes were analysed using random-effects model.

RESULTS

Following critical appraisals using (i) National Institutes of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and (ii) Strengthening the Reporting of Observational Studies in Epidemiology, 21 studies were included. Nursing assistants had greater odds of sickness absence than nurses. Working night shifts, in paediatrics or psychiatric units, experiencing poor mental health, and fatigue, also increased the odds of sickness absence. There was no evidence that job satisfaction or job strain influenced sickness absence; however, job demand increased the likelihood. Finally, work support reduced the odds of lost-time.

CONCLUSIONS

We synthesized three decades of research where several factors influenced sickness absence. Due to limited recent research, the results should be interpreted with caution as some practices may have changed overtime or between countries. Nevertheless, these findings could help in applying preventative strategies to mitigate lost-time in a vulnerable working population.

The Causes of Work Incident According to Work Shift System on Operator of a Woven Bag Company, Sidoarjo

Introduction: In the recent years, woven bag companies have taken a step forward from traditional labor intensive work practices to technological assistance which is operated by workers. Nevertheless, the increased production capability and capacity with assistance of the machineries has been known to cause significant Occupational Safety and Health concerns as having been reported in various previous studies. Therefore, this research aimed to determine the relationship between perception of exposure to hazards and OSH incidents taking into consideration the work shift of the operators. Methods: This research was an analytical observational study with cross-sectional design. There was a total of 67 operators being the population of this study, 53 of whom were recruited as respondents using simple random sampling. The instruments that were used in this research were questionnaires about individual characterization, perception of work environment and work incidents. Variable testing was performed using contingency coefficient. Results: There was a relationship between the complaint towards the noise and the work incident in the morning and afternoon shift. Based on the measurement of the noise, the value was high in the morning of 100dBA, while in the afternoon the value was 91dBA and at night the value was 92 dBA. For the variable of dry temperature, there was a relationship between the complaint towards the dry temperature and the work incident, which showed that in the morning, the dry temperature was 33.1oC. Conclusion: High noise and dry temperature exposure value had a relationship with the work incident on the operators of a Woven Bag Company.Keywords: dry temperature, noise, shift worker, work incident

Understanding sickness absence in nurses and personal support workers: Insights from frontline staff and key informants in Northeastern Ontario

BACKGROUND

Nurses and personal support workers (PSWs) have high sickness absence rates in Canada. Whilst the evidence-based literature helped to identify the variables related to sickness absenteeism, understanding "why" remains unknown. This information could benefit the healthcare sector in northeastern Ontario and in locations where healthcare is one of the largest employment sectors and where nursing staff have high absence and turnover rates.

OBJECTIVE

To identify and understand the factors associated with sickness absence among nurses and PSWs through several experiences while investigating if there are northern-related reasons to explain the high rates of sickness absence.

METHODS

In this descriptive qualitative study, focus group sessions took place with registered nurses (n = 6), registered practical nurses (n = 4), PSWs (n = 8), and key informants who specialize in occupational health and nursing unions (n = 5). Focus group sessions were transcribed verbatim followed by inductive thematic analysis.

RESULTS

Four main themes emerged, which were occupational/organizational challenges, physical health, emotional toll on mental well-being, and northern-related challenges. Descriptions of why such factors lead to sickness absence were addressed with staff shortage serving as an underlying factor.

CONCLUSION

Despite the complexity of the manifestations of sickness absence, work support and timely debriefing could reduce sickness absence and by extension, staff shortage.

Association between night shift and sleep quality and health among Chinese nurses: A cross-sectional study

AIM

To explore the sleep quality among Chinese nurses and identify the association between night shift and sleep quality and health.

BACKGROUND

Chinese nurses have many night shifts; the effect of it regarding nurses' sleep quality and health is still not being explored.

METHODS

This was a cross-sectional study. There were 3,206 nurse participants. The participants self-completed a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and the Cornell Medical Index (CMI).

RESULTS

Night shift nurses demonstrated relatively worse sleep quality (55.1%) and more health problems (20.7%). Night shift work was significantly associated with poor sleep quality (β = 0.96, confidence interval [CI] = 0.67-1.26) and poor health (β = 2.01, CI = 0.15-3.88). Except for sleep medication (β = 0.02, CI = -0.01, 0.05) and psychological health (β = 0.38, CI = -0.27, 1.03), night shift work was significantly associated with other PSQI domains and physical health.

CONCLUSION

Night shift work was a risk factor for nurses' sleep quality and health. Night shift nurses have more sleep disorders and physical health problems.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should pay attention to the impact of shift work on nurses' sleep quality and health and reform the rotating shift work system to improve nurses' occupational health.

Time Trends of Percutaneous Injuries in Hospital Nurses: Evidence of the Interference between Effects of Adoption of Safety Devices and Organizational Factors

Few studies have focused on the combined effects of devices and work organization on needlestick injuries trends. The aim of the study was to estimate trends of percutaneous injury rates (IR) in nurses (N) and nurse assistants (NA) over a 10 year period, in which passive safety devices were progressively adopted. Percutaneous and mucocutaneous injuries registered in a University Hospital in Northern Italy in Ns and NAs in 2007–2016 were analyzed. Organizational data were also available on shift schedules, turnover, downsizing and age- and skill-mix. We estimated IRs per 100 full-time equivalent workers from Poisson models and their average annual percent changes (APC) from joinpoint regression model. In the entire period, monotonic decreases in percutaneous IRs occurred among day-shift Ns (APC = −20.9%; 95% CI: −29.8%, −12%) and NAs (APC = −15.4%; −32.9%, 2.2%). Joinpoint modeling revealed a turning point in 2012 for night-shift Ns, with a steady decline in 2007–2012 (APC = −19.4%; −27.9%, −10.9%), and an increase thereafter (APC = +13.5%; 1.5%, 25.5%). In comparison to 2008 and 2012, in 2016 night-shift Ns were 5.9 and 2.5 times more likely to be younger and less qualified or experienced than day-shift Ns. The observed declines in percutaneous injury rates occurred in a time period when safety devices were progressively implemented. The causal nature of multiple exposures and organizational procedures in affecting injury time trends should be further addressed by quasi-experimental studies.

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study

BACKGROUND

Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs.

METHODS

By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure.

RESULTS

Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively.

CONCLUSIONS

Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.

Mitigating the Adverse Effects of 12-Hour Shifts: Nursing Leaders' Perspectives

OBJECTIVE

The purpose of this study was to explore perspectives of nurse leaders regarding strategies to mitigate the job demands of 12-hour shift work and learn their views regarding the role of breaks in offsetting the cognitive and physical demands of acute care nurses working 12-hour shifts.

BACKGROUND

The strain of long shifts can result in adverse outcomes for nurses, organizations, and patients.

METHODS

A modified, 3-round, e-Delphi solicited input from nurse leaders. First, qualitative information about support and resources to mitigate the adverse effects of 12-hour shifts was collected, and then 2 subsequent rounds used consensus identification and item ranking to develop recommendations.

RESULTS

Findings reinforce that job demands of 12-hour shifts can be mitigated via staffing practices, quiet break spaces, and the opportunity to work with familiar patients.

CONCLUSIONS

Recommendations from this work may enhance patient safety, positive organizational outcomes, and a resilient and sustainable nursing workforce.

Use of Champions Identified by Social Network Analysis to Reduce Health Care Worker Patient-Assist Injuries

BACKGROUND

Safe patient handling and mobility (SPHM) programs recommend having champions, but have not indicated how to identify them and have confined their role to peer-based activities, limiting their ability to influence control measures.

METHODS

In a pilot program conducted at a community access hospital in Oregon, researchers applied social network analysis (SNA) of safety advice to identify champion candidates. Candidates were invited to complete mobility, communication, and quality improvement (QI) training modules to become champions. Champions' roles included peer-based instruction and participation in QI quarterly meetings with hospital leaders. The program process was evaluated through weekly e-mail check-ins and documentation of quarterly meetings. Outcomes were evaluated with a pre-post design, observing 12-month changes in self-reported leading indicators and Good Catch reports, as well as trends in patient-assist injuries (2011-2019).

RESULTS

SNA identified six candidates, four of whom became champions. Champions completed 48 weekly logs. The quarterly meetings concerned unitwide SPHM training, equipment storage, and onboarding. Results showed significant improvements in equipment use, safety participation, and safety compliance, particularly among workers who would seek SPHM advice from champions or recently hired workers. Compared with the prior year, the Good Catch monthly entries increased from 11.69 to 28.81. The average annual incidence rate of patient-assist injuries dropped from 13.01 for the six years before the program to 3.7 per 100 full-time equivalents (FTE) for the two years after.

CONCLUSION

A program with SNA-identified and QI-trained champions improved safety outcomes after one year. Better-designed evaluations are needed to establish the replicability and long-term impact of this program.

Red light: A novel, non-pharmacological intervention to promote alertness in shift workers

INTRODUCTION

Night work requires inversion of the natural, diurnal human activity-rest cycle and is associated with decreased alertness and some measures of performance, reduced safety, adverse health effects, and chronic disruption of the melatonin cycle that has been associated with increased risk for several major diseases. Previous studies show that red light exposures at night can promote alertness and improve performance while not negatively affecting melatonin secretion.

METHOD

This ongoing crossover, mixed (within- and between-subjects) design field study is testing the efficacy and acceptance of red light delivered to day-shift and night-shift workers using personal light glasses while they are at work. Each participant experienced three lighting interventions at the eyes: red light (50 lx, 630 nm, the treatment intervention), blue light (50 lx, 460 nm, the positive control intervention), and dim white light (10 lx, 3,000 K, the placebo control). During the interventions, participants underwent visual performance testing, submitted salivary melatonin and cortisol samples, and provided subjective reports of sleepiness, sleep disturbance, and general health over the 20-week protocol. Due to the ongoing nature of the study, only the performance and subjective reports are presented here.

RESULTS

Preliminary results indicate that response times were improved by the red and blue interventions, but not accuracy and hit rates. Blue light was associated with improvements to self-reported sleep disturbances compared to dim light.

CONCLUSIONS

These field results partially support our laboratory results that showed a positive effect of red light for promoting alertness and certain performance outcomes during the day and at night. Practical Applications: Red light may be used to improve response times in shift workers. Continued research will elucidate the lighting interventions' effects on melatonin and objective sleep measures (actigraphy).

Night work for hospital nurses and sickness absence: a retrospective study using electronic rostering systems

There is conflicting evidence on the effect of night work on sickness absence. Most previous studies used self-reporting to identify shift patterns and measure levels of sickness absence. In contrast, this study used objective data from electronic rosters to explore the association of nurses' patterns of night work and sickness absence. This was a retrospective longitudinal study of nurse roster data from 32 general medical and surgical wards in a large acute hospital in England. We used data from 3 years and included both registered nurses and unregistered nursing assistants. We used generalized linear-mixed models to explore the association between night work and the subsequent occurrence of sickness absence. Of 601,282 shifts worked by 1944 nursing staff, 38,051 shifts were lost due to sickness absence. After controlling for potential confounders including proportion of long (≥12 h) shifts worked, proportion of overtime shifts, proportion of shifts worked in the past 7 days, and staff grade, we found that staff working more than 75% of their shifts in the past 7 days as night shifts were more likely to experience sickness absence (aOR = 1.12; 95% CI: 1.03-1.21), compared to staff working on day only schedules. Sub-group analysis found that an association between a high proportion of night shifts worked and long-term sickness (aOR = 1.31; 95% CI: 1.15-1.50), but not short-term sickness. Working high proportions of night shifts, likely representing permanent night work schedules, is associated with a higher risk of long-term sickness absence for nurses working in inpatient adult wards in acute hospitals. The higher sickness absence rates associated with permanent night shifts could result in additional costs or loss of productivity for hospitals. This study challenges the assumption that permanent night schedules maximize circadian adjustment and, therefore, reduce health problems.

The association between shift patterns and the quality of hand antisepsis in a neonatal intensive care unit: An observational study

BACKGROUND

Healthcare-associated infections represent a major burden in neonatal intensive care units. Hand antisepsis is the most important tool for prevention, however, compliance among healthcare workers remains low.

OBJECTIVES

To prospectively evaluate the influence of different work shifts (extended working hours, night shifts) on the quality of healthcare workers' hand antisepsis.

DESIGN

Observational study.

SETTINGS

Two equivalent "Level III" neonatal intensive care units at the University Hospital Vienna, Austria.

PARTICIPANTS

Seventy healthcare workers, 46 nurses and 24 physicians.

METHODS

The Semmelweis Scanner, an innovative training device assessing the quality of hand antisepsis with an ultraviolet dye labelled alcohol-based hand rub, was employed to collect data on the hand surface coverage achieved during hand antisepsis of participants. It provides visual feedback of appropriately versus inappropriately disinfected areas of the hand and can also be used for the objective quantification of hand surface coverage with the hand rub. Measurements were performed before and after 12.5 h (h) day and night shifts (nurses), as well as before and after regular 8 h day shifts and extended 25 h shifts (physicians). To avoid any bias caused by residual ultraviolet marker, scans had to be separated by 24 h periods. Primary outcome was the hand surface coverage with the hand rub: Hand scans were categorized as "passed" if an appropriate quality of hand hygiene, defined as a minimum 97% coverage of hand surface, was achieved. A generalized mixed model was used to analyse the data accounting for repeated measurements.

RESULTS

Seventy healthcare workers performed a total of 485 scans. Nineteen scans had to be excluded, resulting in 466 scans for further analyses. A difference in the predicted probability of achieving appropriate hand antisepsis was found between the beginning and end of extended shifts: In physicians, adequate hand antisepsis was remarkably reduced after 25 h shifts (predicted probability 99.4% vs 78.8%), whereas there was no relevant difference between the beginning and end of 8 h day shifts (92.2% vs 97.3%). In nurses, a relevant difference was found between the beginning and end of 12.5 h day shifts (88.6% vs 73.6%). This difference was not found for 12.5 h night shifts. The most frequently missed area on the hands was the right dorsum.

CONCLUSION

The quality of hand antisepsis of healthcare workers in neonatal intensive care units may be associated with long working hours.

Factors affecting the occupational accident rates among nurses

OBJECTIVE

In this hospital-based study, we aimed to determine occupational accident perceptions and occupational accident reasons in sample of Turkish nurses.

METHOD

In the study, the Epworth Sleepiness Scale, the Workload Scale and a Study Questionnaire Form including the employment characteristics of the nurses, their socio demographic characteristics, and the occupational accidents they encountered.

RESULTS

108 nurses (90 females, 18 males; mean age, 26.42±5.5 years) participated in the study. 68.5% of nurses have undergone at least once a occupational accident. Most of the participants were found to have experienced occupational accidents with approximately half evaluating their occupational accidents risk as high. Most of the nurses worked overtime and in shifts. The mean total scores for the Epworth Sleepiness Scale and Workload Scale were respectively 9.09±3.33 and 36.94±6.42. Statistically significant differences in occupational accidents were found with regard to Epworth Sleepiness Scale and Workload Scale scores, working in shifts, and working overtime (p<0.05).

CONCLUSION

It was concluded that nurses had very high rates of occupational accidents and that the heavy work conditions affected occupational accidents.

Organization of Work Factors Associated with Work Ability among Aging Nurses

The United States (U.S.) workforce is aging. There is a paucity of literature exploring aging nurses' work ability. This study explored the work-related barriers and facilitators influencing work ability in older nurses. We conducted a qualitative descriptive study of aging nurses working in direct patient care (N = 17). Participants completed phone or in-person semi-structured interviews. We used a content analysis approach to analyzing the data. The overarching theme influencing the work ability of aging nurses was intrinsically motivated. This was tied to the desire to remain connected with patients at bedside. We identified factors at the individual, unit-based work level and the organizational level associated with work ability. Individual factors that were protective included teamwork, and feeling healthy and capable of doing their job. Unit-based level work factors included having a schedule that accommodated work-life balance, and one's chronotype promoted work ability. Organizational factors included management that valued worker's voice supported work ability.

Assessing and preventing low back pain in nurses. Implications for practice management

Background and aims:

The prevention of low back pain (LBP) among nurses employed in hospital departments represents a special concern for healthcare organizations globally. A growing literature evidences the need of workplace policy development related to organizational issues as strategic contribution to minimize the occurrence of LBP in healthcare sector. The purposes of this study were: 1) to analyze the relationship between shiftwork and acute LBP among female shift nurses; 2) to detect preventive interventions targeted on organizational issues.

Methods:

The authors conducted a cross-sectional nested case-control analysis of data concerning acute LBP and staffing data for 671 nurses employed in the Departments of General Practice and Elderly Care Medicine. The statistical analysis consisted of a logistic regression to calculate incidence odds ratios with 95% confidence intervals. Chi-square test and t-test were used to examine the relationship between categorical and continuous data, respectively.

Results:

The occurrence of acute LBP resulted significantly related to nightshift, extended shifts, obesity; the adoption of forward rotating schedules was found a protective factor in moderating the occupational risk of acute LBP in shift nurses.

Conclusions:

In this study the authors observed an association between shiftwork and acute LBP; improvement interventions should be aimed at: 1) moderating organizational risks linked with shiftwork schedules; 2) promoting healthy lifestyles. These interventions are suggested as a strategic way to effectively manage the phenomenon among female rotating shift nurses. (www.actabiomedica.it)

Balance, Health, and Workplace Safety: Experiences of New Nurses in the Context of Total Worker Health

Transitioning into independent professional practice may be a difficult and trying process for newly licensed nurses, who may be at risk for burnout and quitting their jobs. Issues related to new nurses’ well-being at work may also impact their personal lives. Using thematic analysis within the framework of Total Worker Health, this study examined factors related to the overall work, safety, and health of newly licensed nurses that should be addressed in work environments to promote well-being and prevent burnout and attrition. The main component of Total Worker Health is to find and understand the relevant issues that lead to safety and health risks in the workplace and affect workers’ well-being at work and home. The overarching concept of Balance between Work and Life included three main themes: Health, Work Environment, and Learning to Be (a nurse). These themes with their subthemes described the difficulties participants had in balancing the complex interactions of work conditions and social life changes during the transition from student to professional nurse. Participants identified new physical health problems, mental health challenges, physical violence, lack of support structures at work, and alterations in family and friend relationships. However, they also developed protective factors from new connections with coworkers. These findings showed that new nurses are vulnerable to many factors at home and work that affect well-being and may lead to burnout and attrition. Implications include interventions at work that focus on health promotion, group support, and safety risk prevention through occupational nurse management.

Impact of morning and rotational duties on physical health of nurses working in tertiary care hospitals of Karachi

Background & Objectives:

In the system related to health care, shifting duties are considered essential and obligatory to make sure the stability of care in hospitals. Scheduling and shifting are the key uniqueness of shift work and nurses are mostly bounded into different schedules that facilitate 24-hour care. Our objective was to identify the impact of morning and rotational duties on physical health of nurses working in tertiary care hospitals.

Methods:

A total of 154 nurses from two tertiary care hospitals in Karachi were included in this study. Data were collected through the Short Form Health Servay-26 between May to June 2017. Questionnaire form consisted of five domains including Physical functioning, Role limitations due to physical health, Energy/Fatigue, Pain and General health.

Results:

Most of the study participants were staff nurses (66.9%) and few were head nurse and assistant head nurses 13.6% and 8.4% respectively. Nurses’ characteristics such as gender, age, educational level, designation and monthly income were found significant with duty shift with p-values 0.049, 0.007, <0.001 and 0.017 respectively. Energy/Fatigue was only domain of SF-26 which showed significant mean difference (p-value <0.001) between morning and rotational duties.

Conclusion:

This research concludes that nurses working in rotational duties were more prone to develop physical problem as compared to morning duties. Energy/Fatigue showed significant mean difference.

Burnout Syndrome and shift work among the nursing staff

Objective:

to analyze the factors associated with Burnout Syndrome among nursing workers according to work shift.

Method:

cross-sectional study addressing a representative sample of 502 nursing workers from a philanthropic hospital facility. Data were collected using a characterization instrument, the Maslach Burnout Inventory - Human Service Survey and the Demand-Control-Support Questionnaire. Data were analyzed using descriptive statistics and multiple binary logistic regression.

Results:

levels of Burnout Syndrome were significantly higher among those working the day shift and associated factors included: high demand; low control; low social support; dissatisfaction with sleep and financial resources; being a nurse; and sedentariness. Professionals working the night shift, having low social support, being dissatisfied with sleep, having children, not having a religion, having worked for a short period in the institution, and being a nursing technician or aid were significantly more likely to experience high levels of the syndrome.

Conclusion:

psychosocial factors and factors from the work context, mainly low social support, were associated with the syndrome dimensions among nursing workers of both shifts.

Are long nursing shifts on hospital wards associated with sickness absence? A longitudinal retrospective observational study

Objective

To investigate whether working 12 hr shifts is associated with increased sickness absence among registered nurses and health care assistants.

Background

Previous studies reported negative impacts on nurses’ 12 hr shifts; however, these studies used cross‐sectional techniques and subjective nurse‐reported data.

Methods

A retrospective longitudinal study using routinely collected data across 32 general inpatient wards at an acute hospital in England. We used generalized linear mixed models to explore the association between shift patterns and the subsequent occurrence of short (<7 days) or long‐term (≥7 days) sickness absence.

Results

We analysed 601,282 shifts and 8,090 distinct episodes of sickness absence. When more than 75% of shifts worked in the past 7 days were 12 hr in length, the odds of both a short‐term (adjusted odds ratio = 1.28; 95% confidence index: 1.18–1.39) and long‐term sickness episode (adjusted odds ratio = 1.22; 95% confidence index: 1.08–1.37) were increased compared with working none.

Conclusion

Working long shifts on hospital wards is associated with a higher risk of sickness absence for registered nurses and health care assistants.

Implications for Nursing Management

The higher sickness absence rates associated with long shifts could result in additional costs or loss of productivity for hospitals. The routine implementation of long shifts should be avoided.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.

The associations of occupational hazards and injuries with work environments and overtime for nurses in China

Occupational hazards (OHs) and occupational injuries (OIs) may contribute to nurses needing sick time and to a high financial burden for hospitals. There is little published literature about nurse-reported OHs/OIs and their relationships with work environments and working overtime in China. This study was designed to describe Chinese hospital registered nurses' OHs/OIs and to explore the associations between work environments, working overtime, and nurse-reported OHs/OIs. This cross-sectional study was conducted in Guangdong province in China in 2014. The sample included 1,517 nurses from 111 medical/surgical units in 23 hospitals. The Practice Environment Scale of the Nursing Work Index was used to measure work environment. Overtime was calculated by subtracting scheduled work hours from actual work hours. Six items were used to measure nurse-reported OHs/OIs. Descriptive statistics, Chi-square tests, and two-level logistic regression models were used to analyze the data. The percentages of nurses reporting OHs/OIs occurred in the year before the survey ranged from 47% to 80%. Nurses who worked in good (vs. poor) unit work environments were less likely to experience OHs/OIs (Odds ratio [OR] = 0.65-0.68, p < .05). Nurses who worked overtime (OR = 1.19-1.33, p < .05) and in Level 3 (largest) hospitals (OR = 1.45-1.80, p < .05) were more likely to experience OHs/OIs. We found that OHs/OIs were prevalent among hospital nurses in China. Better work environment and less nurse overtime were associated with fewer nurse OHs/OIs.

The Impact of a Rigorous Multiple Work Shift Schedule and Day Versus Night Shift Work on Reaction Time and Balance Performance in Female Nurses: A Repeated Measures Study

OBJECTIVE

The aim of this study was to determine the impact of a demanding work schedule involving long, cumulative work shifts on response time and balance-related performance outcomes and to evaluate the prevalence of musculoskeletal disorders between day and night shift working nurses.

METHODS

A questionnaire was used to identify the prevalence of past (12-month) and current (7-day) musculoskeletal disorders. Nurses worked three 12-hour work shifts in a 4-day period. Reaction time and balance tests were conducted before and after the work period.

RESULTS

The work period induced impairments for reaction time, errors on reaction time tasks, and balance performance, independent of shift type. Musculoskeletal symptom prevalence was high in workers of both work shifts.

CONCLUSIONS

Compressed work shifts caused performance-based fatigue in nurses. Reaction time and balance tests may be sensitive fatigue identification markers in nurses.

The Effect of Zinc Supplementation on Sleep Quality of ICU Nurses: A Double Blinded Randomized Controlled Trial

This study examined the effect of zinc supplementation on the sleep quality (SQ) of intensive care unit (ICU) nurses. In a double-blind, randomized controlled trial, 54 ICU nurses were randomly assigned to the intervention group ( n = 27) that received 220 mg zinc sulfate capsules every 72 hours for 1 month and the control group ( n = 26) that received placebo. Sleep quality of ICU nurses was measured by calculating the total quality sleep score using the Pittsburgh Sleep Quality Index (PSQI). The serum zinc level was a secondary outcome. All measurements were calculated at both baseline and 1 month after intervention. The total PSQI, subjective SQ, and sleep latency scores for the intervention group were significantly lower than the control group, which means that the SQ of ICU nurses in the intervention group improved from baseline. The serum zinc level of the intervention group at the end of the study was significantly higher than the control group, which means that zinc supplementation improved participants’ serum zinc level. Based on these findings, the researcher suggested that zinc supplementation could be associated with better SQ, subjective SQ, and sleep latency in this group of workers.

Smoked marijuana attenuates performance and mood disruptions during simulated night shift work

Individuals who work nonstandard schedules, such as rotating or night shifts, are more susceptible to workplace injuries, performance decrements, and reduced productivity. This population is also almost twice as likely to use illicit drugs as individuals working a standard day shift. The purpose of this study was to examine the effects of smoked marijuana on performance, mood, and sleep during simulated shift work. Ten experienced marijuana smokers completed this 23-day, within-participant residential study. They smoked a single marijuana cigarette (0, 1.9, 3.56% Δ⁹-THC) one hour after waking for three consecutive days under two shift conditions: day shift and night shift. Shifts alternated three times during the study, and shift conditions were separated by an 'off' day. When participants smoked placebo cigarettes, psychomotor performance and subjective-effect ratings were altered during the night shift compared to the day shift: performance (e.g., vigilance) and a few subjective ratings were decreased (e.g., "Self-Confident"), whereas other ratings were increased (e.g., "Tired"). Objective and subjective measures of sleep were also disrupted, but to a lesser extent. Marijuana attenuated some performance, mood, and sleep disruptions: participants performed better on vigilance tasks, reported being less miserable and tired and sleep a greater number of minutes. Limited negative effects of marijuana were noted. These data demonstrate that abrupt shift changes produce performance, mood, and sleep decrements during night shift work and that smoked marijuana containing low to moderate Δ⁹-THC concentrations can offset some of these effects in frequent marijuana smokers.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BACKGROUND

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed.

OBJECTIVES

To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan.

DESIGN

Cross-sectional survey.

SETTINGS/PARTICIPANTS

This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan.

METHODS

Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model.

RESULTS

More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia.

CONCLUSIONS

This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.

The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts

BACKGROUND

Shift work is considered necessary to ensure continuity of care in hospitals and residential facilities. In particular, the night shift is one of the most frequent reasons for the disruption of circadian rhythms, causing significant alterations of sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance.

OBJECTIVES

The aim of this study was to highlight if shift work with nights, as compared with day work only, is associated with risk factors predisposing nurses to poorer health conditions and lower job satisfaction.

METHODS

This cross-sectional study was conducted from June 1, 2015 to July 31, 2015 in 17 wards of a general hospital and a residential facility of a northern Italian city. This study involved 213 nurses working in rotating night shifts and 65 in day shifts. The instrument used for data collection was the "Standard Shift Work Index," validated in Italian. Data were statistically analyzed.

RESULTS

The response rate was 86%. The nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelors and Masters degrees in nursing. They reported the lowest mean score in the items of job satisfaction, quality and quantity of sleep, with more frequent chronic fatigue, psychological, and cardiovascular symptoms in comparison with the day shift workers, in a statistically significant way.

CONCLUSION

Our results suggest that nurses with rotating night schedule need special attention due to the higher risk for both job dissatisfaction and undesirable health effects.

Mediating pathways and gender differences between shift work and subjective cognitive function

OBJECTIVES

Increased injury risk among shift workers is often attributed to cognitive function deficits that come about as a result of sleep disruptions. However, little is known about the intermediate influences of other factors (eg, work stress, health) which may affect this relationship. In addition, gender differences in these the complex relationships have not been fully explored. The purpose of this study is to (1) identify the extent to which work and non-work factors mediate the relationship between shift work, sleep and subsequent subjective cognitive function; and (2) determine if the mediating pathways differ for men and women.

METHODS

Data from the 2010 National Population Health Survey was used to create a cross-sectional sample of 4255 employed Canadians. Using path modelling, we examined the direct and indirect relationships between shift work, sleep duration, sleep quality and subjective cognitive function. Multigroup analyses tested for significantly different pathways between men and women. Potential confounding effects of age and self-reported health and potential mediating effects of work stress were simultaneously examined.

RESULTS

Work stress and sleep quality significantly mediated the effects of shift work on cognition. Age and health confounded the relationship between sleep quality and subjective cognition. No differences were found between men and women.

CONCLUSIONS

Occupational health and safety programmes are needed to address stress and health factors, in addition to sleep hygiene, to effectively address cognitive function among shift workers.