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Booker LA, Mills J, Bish M, Spong J, Deacon-Crouch M, Skinner TC. Nurse rostering: understanding the current shift work scheduling processes, benefits, limitations, and potential fatigue risks. BMC Nurs 2024; 23:295. [PMID: 38685019 PMCID: PMC11057102 DOI: 10.1186/s12912-024-01949-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/18/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Implementing appropriate shift work schedules can help mitigate the risk of sleep impairment and reduce fatigue of healthcare workers, reducing occupational health and safety risks. In Australia, the organisation has a responsibility to make sure all reasonable measures are taken to reduce fatigue of staff. Therefore, it is important to assess what the current rostering processes is for staff responsible for creating the rosters for nurses. AIM The aims of the project were to understand (1) who creates the rosters and what the process is, (2) what training and knowledge these staff have in establishing rostering schedules that optimise the sleep and wellbeing of staff, and (3) what the benefits and limitations are of current rostering practices. METHODS Findings were generated through semi-structured interviews, using cluster coding to form categories. Twenty four nurses responsible for rostering staff were interviewed from three different sites in Victoria (one metropolitan and two regional/rural hospitals). Data was analysed using selected grounded theory methods with thematic analysis. RESULTS The common themes that came out of the interviews were that rostering staff were under prepared, unaware of fatigue and safety guidelines and polices from governing bodies and had not received any education or training before taking on the role. The most common rostering style was self-rostering, where staff could submit preferences. However, there were concerns about staff fatigue but were divided as to who should be responsible, with many saying it was up to staff to preference shifts that they could cope with. The final theme was cultural barriers to change. CONCLUSION While self-rostering resulted in staff having more freedom and flexibility, shift preferences may be influenced more so by a need to fit with lifestyle rather than to minimise fatigue and increase safety in the workplace. Greater consideration of the impact of shift work schedules on fatigue is required to ensure that the layers of clinical governance in health care organisations minimise the risk of occupation health and safety issues for employees delivering direct patient care.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, VIC, 3552, Australia.
- Institute for Breathing and Sleep, Austin Health, Melbourne, 3084, Australia.
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Jo Spong
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, 3084, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, VIC, 3552, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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Booker LA, Fitzgerald J, Mills J, Bish M, Spong J, Deacon‐Crouch M, Skinner TC. Sleep and fatigue management strategies: How nurses, midwives and paramedics cope with their shift work schedules-a qualitative study. Nurs Open 2024; 11:e2099. [PMID: 38268269 PMCID: PMC10803889 DOI: 10.1002/nop2.2099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 12/07/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
AIMS To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift work. DESIGN A single case study with embedded units. METHODS Twenty-seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022. RESULTS Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long-term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations. CONCLUSION This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessary information, training and guidance to staff on how to reduce fatigue risk is required. PATIENT OR PUBLIC CONTRIBUTION This study involved healthcare shift workers in semi-structured interviews. Data gathered from a previous survey that participants were involved in helped shape the interview topics and the study design.
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Affiliation(s)
- Lauren A. Booker
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
| | - Jarrah Fitzgerald
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melissa Deacon‐Crouch
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Timothy C. Skinner
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Department of Psychology, Centre for Health and SocietyUniversity of CopenhagenCopenhagenDenmark
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Kawata Y, Kuroda S, Owan H. The impact of a mobile app-based corporate sleep health improvement program on productivity: Validation through a randomized controlled trial. PLoS One 2023; 18:e0287051. [PMID: 37796855 PMCID: PMC10553342 DOI: 10.1371/journal.pone.0287051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/27/2023] [Indexed: 10/07/2023] Open
Abstract
Based on a randomized controlled trial applied to employees of a manufacturing company, this study examines the extent to which a corporate sleep program improves workers' sleep health and productivity. In the three-month sleep improvement program, applicants were randomly divided into a treatment group and a control group, and the treatment group was provided with a noncontact sensing device to visualize their sleep. A smartphone app linked to the device notified them of their sleep data every morning and presented them with advice on behavioral changes to improve their sleep on a weekly basis. The results of the analysis revealed the following. First, even after controlling for factors that may cause sleep disturbances and nocturnal awakenings, such as increased workload and the number of days spent working from home during the measurement period, the treatment group showed improved sleep after the program compared to the control group. Second, the treatment group showed statistically significant improvement in presenteeism (productivity). The effect size on presenteeism through sleep improvement was similar regardless of the estimation method used (i.e., ANCOVA estimator of ATT and two 2SLS methods were performed). In particular, we confirmed that productivity was restored through sleep improvement for the participants who diligently engaged in the program. These results suggest that promoting sleep health using information technology can improve sleep deficiency and restore productivity.
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Affiliation(s)
- Yuji Kawata
- Graduate School of Economics, Waseda University, Tokyo, Japan
| | - Sachiko Kuroda
- Faculty of Education and Integrated Arts and Sciences, The Research Institute of Economy, Trade and Industry, Waseda University, Tokyo, Japan
| | - Hideo Owan
- Faculty of Political Science and Economics, The Research Institute of Economy, Trade and Industry, Waseda University, Tokyo, Japan
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Takano Y, Iwano S, Aoki S, Nakano N, Sakano Y. A systematic review of the effect of sleep interventions on presenteeism. Biopsychosoc Med 2021; 15:21. [PMID: 34789296 PMCID: PMC8597302 DOI: 10.1186/s13030-021-00224-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/01/2021] [Indexed: 01/08/2023] Open
Abstract
Background Sleep problems interfere with work performance. Decreased work productivity due to health problems is defined as presenteeism. Although empirical data on the improvement of presenteeism by sleep interventions have been published, a systematic review elucidating whether there is a difference in the improvement of presenteeism across various types of sleep interventions has not yet been published. This systematic review of studies aimed to clarify which sleep interventions are more likely to be effective in improving presenteeism. Methods The electronic databases PubMed, PsycINFO, and MEDLINE were used to perform a literature search (the start and end search dates were October 20, 2019, and March 11, 2020, respectively). A combination of terms such as “employee*,” “sleep,” “insomnia,” and “presenteeism” was used for the search. Both randomized and non-randomized control trials were included in this systematic review. Results Six types of sleep interventions were identified, including cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene education, yoga, mindfulness, weight loss program, and changing the color temperature of fluorescent lights in the workplace. Only CBT-I improved both sleep problems and presenteeism compared with a control group. The results of this review also show that there is heterogeneity in the measurement of presenteeism. Conclusions The results of this systematic review suggested that CBT-I could be adapted for workers with sleep problems and presenteeism. We discussed whether CBT-I improved both sleep problems and presenteeism compared with other interventions. In addition, methods for measuring presenteeism in future research are proposed.
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Affiliation(s)
- Yuta Takano
- Department of Psychology, Fukuyama University, 985-1 Sanzo, Higashimura-Cho, Fukuyama, Hiroshima, 729-0292, Japan. .,Graduate School of Psychological Science, Health Sciences University of Hokkaido, 2-5 Ainosato, Kita-ku, Sapporo, Hokkaido, 002-8072, Japan.
| | - Suguru Iwano
- Faculty of Welfare and Health Science, Oita University, 700 Dannoharu, Oita City, Oita, 870-1192, Japan
| | - Shuntaro Aoki
- Center for Medical Education and Career Development, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.,Department of Neuropsychiatry, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Norihito Nakano
- School of Psychological Science, Health Sciences University of Hokkaido, 2-5 Ainosato, Kita-ku, Sapporo, Hokkaido, 002-8072, Japan
| | - Yuji Sakano
- Sapporo CBT & EAP Center, Goryokai Medical Corporation, Shinoro 8-jo 6-chome 7-6, Kita-ku, Sapporo, Hokkaido, 002-8028, Japan
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Schultz AB, Burton WN. Sleep: An Integral Component of Employee Well-Being Programs. Am J Health Promot 2019; 32:1639-1641. [PMID: 30099898 DOI: 10.1177/0890117118790621c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Effectiveness of a Blended Web-Based Intervention to Raise Sleep Awareness at Workplace. J Occup Environ Med 2019; 61:e253-e259. [DOI: 10.1097/jom.0000000000001589] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE Poor sleep can impact occupational functioning. The current study examines health risks, medical conditions, and workplace economic outcomes associated with self-reported hours of sleep among employees. METHODS Employees of a global financial services corporation were categorized on the basis of their self-reported average hours of sleep. Differences in health care costs, productivity measures, health risks, and medical conditions were analyzed by hours of sleep while controlling for confounding variables. RESULTS A strong U-shaped relationship between health care costs, short-term disability, absenteeism, and presenteeism (on-the-job work loss) and the hours of sleep was found among employees. The nadir of the "U" occurs for 7 or 8 hours of sleep per night. CONCLUSIONS Worksite wellness programs often address health risks and medical conditions and may benefit from incorporating sleep education.
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Lucas G, Neeper M, Linde B, Bennett J. Preventing Prescription Drug Misuse in Work Settings: Efficacy of a Brief Intervention in Health Consciousness. J Med Internet Res 2017; 19:e242. [PMID: 28684383 PMCID: PMC5519829 DOI: 10.2196/jmir.7828] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND It is becoming more commonplace for employees to use prescription medication outside of intended use. Opioid and other prescription misuse has implications for the health and productivity of workers. Easy-to-access webinars that help employees learn about alternatives to prescription use may decrease risk. OBJECTIVE The aim of this study was to examine the efficacy of an interactive but brief health consciousness and prescription drug intervention for a diverse sample of employees and show effectiveness via both Internet-delivered webinar and classroom delivery. METHODS Employees from a variety of workplaces filled out pre- and post-questionnaires upon completion of a one-hour long intervention. RESULTS A total of 114 participants completed the pre- and post-questionnaires. Results showed that, compared with before the training, participants reported significantly more knowledge about prescription drug misuse and alternatives to prescription drug use after the training (t113=7.91, P<.001). Moreover, the medium of presentation (ie, face-to-face vs webinar) did not significantly impact effectiveness of the training (F1,98=1.15, P=.29). CONCLUSIONS In both webinar and classroom formats, participants gained knowledge about alternatives to prescription drug use. This intervention appears to be beneficial to employees and assists in the awareness of prescription drug use in general and in the workplace.
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Affiliation(s)
- Gale Lucas
- Organizational Wellness and Learning Systems, Fort Worth, TX, United States
| | - Michael Neeper
- Organizational Wellness and Learning Systems, Fort Worth, TX, United States
| | - Brittany Linde
- Organizational Wellness and Learning Systems, Fort Worth, TX, United States
| | - Joel Bennett
- Organizational Wellness and Learning Systems, Fort Worth, TX, United States
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Chen CY, Schultz AB, Li X, Burton WN. The Association Between Changes in Employee Sleep and Changes in Workplace Health and Economic Outcomes. Popul Health Manag 2017; 21:46-54. [PMID: 28486056 DOI: 10.1089/pop.2016.0169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Sleep disturbance is negatively associated with workplace productivity. This study sought to identify whether or not changes in sleep from 2012 to 2013 were associated with changes in health risks, medical conditions, or workplace economic outcomes. Employees of a Fortune 100 financial services corporation were categorized based on changes in self-reported hours of sleep from 2012 to 2013 and compared based on their health risk factors, medical conditions, health care costs, and productivity measures. Consistently poor sleepers had more health risks and medical conditions compared to consistently optimal sleepers. Sleep improvers had a significant reduction in lost on-the-job productivity while consistently poor sleepers and downgraders had significantly more lost productivity compared to optimal sleepers. Employers may wish to incorporate sleep education initiatives as part of their overall health and wellness strategy.
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Affiliation(s)
- Chin-Yu Chen
- 1 Health Management Research Center, University of Michigan , Ann Arbor, Michigan
| | - Alyssa B Schultz
- 1 Health Management Research Center, University of Michigan , Ann Arbor, Michigan
| | - Xingquan Li
- 1 Health Management Research Center, University of Michigan , Ann Arbor, Michigan
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