...Running head: THE IMPAIRED NURSE: SLEEP DEPRIVATION The Impaired Nurse: Sleep Deprivation Amber Nye, SN Our Lady of Lourdes School of Nursing The Impaired Nurse: Sleep Deprivation The impaired nurse is a major subject matter in evidence based research. Healthcare services are available twenty four hours a day, three hundred-sixty five days a year. With that being stated, shift work is a requirement in the healthcare field. Sleep deprivation is the lack of sleep due to an external stimulus preventing the opportunity of sleeping and this is a commonly known result of shift work in nurses. Sleep disorders commonly occur with nurses who work rotating shifts. Sleep quality is important, but sleep is not just about how many hours you get. Night shift workers have to sleep during the day which may interfere with their body’s rhythm telling them it is daytime and this jeopardizes their sleeping. This is where sleep deprivation comes into play. Shift work is a major source of disturbances in the healthcare profession. Most healthcare employees have no say over which shift they work. Chan (2008) studied this by using subjective measurements. The Karolinska Sleep Questionnaire was used to address nurses’ sleep patterns. Chan (2008) found that sleep deprivation causes symptoms such as arousals, exacerbations of gastrointestinal problems, and lowers threshold. This is because the stress system is activated by this sleep situation and neuro-hormonal...
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... | |Authors | Authors |Resource/ Database |Year of Publication |Research Type |Population/ Sample Size |Outcome Variables Measured |Pertinent Data from Results |Author’s Suggested Conclusions |Comments | |Chou, Y., Shao, M.,Tzeng, W.& Yeh, M. |WGU Library |2010 |Cross-sectional |435 female nurses from five different hospitals |Sleep quality and quality of life in female shift-working nurses |57% had global sleep-quality scores > or = to 5 |Long hours affect nurses sleep quality and information should be given while in school and to managers to improve health |It was interesting to see the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument-BREF to be used | |Note: If you locate your articles in the WGU library, you may indicate this in place of the database. Note: Assure you understand the definition of primary research. You cannot use evidence summaries, reviews of literature, guidelines, or standards for your ten pieces of research. Note: Tables/Matrices in APA...
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...The Impact of Shift Work on Nurses The Impact of Shift Work on Nurses The purpose of this paper is to discuss nursing shift work and its impact on nursing staff health and family life. The position of the International Council of Nurses is quoted below. It is their position that shift work is detrimental. Position Statement: “The International Council of Nurses (ICN) recognizes that many nursing services must be accessible on a twenty-four basis, making shift work a necessity. At the same time ICN is very concerned that shift work may have a negative impact on an individual’s health, ability to function, immediate support group and the continuity of care, thus affecting the services provided” (ICN, 2007). The impact of shift work on nurses affects productivity at work. Nursing leaders should also encourage work place cultures that respect nurses’ days off and vacation time, promote nurses’ prompt departure and allow nurses to refuse to work overtime without retribution. Traditional eight hour shifts are becoming a thing of the past, twelve hours days and night shift are the norm providing flexibility and a balance family life. Because of unforeseen circumstances such as nurses calling out, change in patients’ condition, short staff on the schedule which was posted two weeks ago, hence the reason twelve hour shift becomes an unplanned longer shift. According to the article in the Journal of Nursing Law, “Compounding the situation nurses work long shifts and often have...
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...and how this task is performed. A nurse has an important role in health promotion. To perform these tasks the author has chosen a nuclear family. By the use of family focused open ended questions, 11 functional health patterns were covered. This principle is known as the Gordon’s functional health patterns. This assessment tool included 11 systematic principles for data collection of the family, and assists the nurses to develop a nursing diagnosis and appropriate interventions. Using Gordon’s functional health patterns, this paper will summarize the findings of each health pattern as well as the family based nursing diagnosis of each assessment. This paper will also discuss different health promotion strategies along with web-based resources, also including a system based theory guide in family assessment. The assessment began with a health perception and health management pattern in which the family verbalized different health practices and habits for preventing illness and maintain health. The selected family was a young couple who has been married for 11 years, and has three children. The father is 39 years old, the mother is 36 years old, and their children’s ages are 10, 7, and 2. Based on the health perception and health management, the family verbalized that they do not smoke or drink alcohol, eat three meals per day, and all three children are up to date with immunizations. Based on the nutritional metabolic pattern question, the family stated that they...
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...and how this task is performed. A nurse has an important role in health promotion. To perform these tasks the author has chosen a nuclear family. By the use of family focused open ended questions, 11 functional health patterns were covered. This principle is known as the Gordon’s functional health patterns. This assessment tool included 11 systematic principles for data collection of the family, and assists the nurses to develop a nursing diagnosis and appropriate interventions. Using Gordon’s functional health patterns, this paper will summarize the findings of each health pattern as well as the family based nursing diagnosis of each assessment. This paper will also discuss different health promotion strategies along with web-based resources, also including a system based theory guide in family assessment. The assessment began with a health perception and health management pattern in which the family verbalized different health practices and habits for preventing illness and maintain health. The selected family was a young couple who has been married for 11 years, and has three children. The father is 39 years old, the mother is 36 years old, and their children’s ages are 10, 7, and 2. Based on the health perception and health management, the family verbalized that they do not smoke or drink alcohol, eat three meals per day, and all three children are up to date with immunizations. Based on the nutritional metabolic pattern question, the family stated that they...
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...Clinical Issue Article - Step 4 The working patterns of the Registered Nurse (RN) have caught the attention of researchers in the last 15 years. The mounting evidence illustrates a direct correlation between long working hours and poor patient outcomes as evidenced by an increase in patient errors, near sentinel events, and injuries to the nurse. The sentence outline is a clear and concise method of uniting the original study question of patient quality care outcomes directly affected by nursing hours worked and the major facts of the research evidence to support the conclusions and findings of the study. I. Clinical Issue Chosen: PICO format a. Problem/Population of Interest i. Registered nurses care for patients in a variety of settings, including hospitals that require 24-hour nursing coverage. ii. Does an RN working eight- or 12-hour shift create potential hazard to patient safety? b. Intervention of Interest i. Nurses who work eight-hour shifts do not cause an increased risk to patient safety. c. Comparison of Interest i. Nurses who work 12-hour shifts may increase the risk of errors and may potentially negatively affect patient care. d. Outcome i. XXXXXXX I don’t know what to put here… I’ve struggled with this part all along. I don’t know what it is????? II. Literature Search (Quantitative) a. Extended work shifts may predispose nurses to make more errors. i. Evidence supports that nurses working beyond a 12-hour shift may directly affect patient mortality...
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...Introduction 12-Hour shifts have constantly been an argument in the field of nursing. This topic interests me because there is constant jitter around this topic in the nursing field, about whether these shifts are safe, or not. This can be taken into view from the patients view and also the nurses. Many people would support a side that nurses working these long 12-hour shifts could lead to accidents in the working environment. There are also people who would argue that these shifts benefit the patient/nurse relationship, and is more beneficial because there is only three shifts per week. Nurses should not be allowed to work 12-hour shifts because, the physical and emotional impact on their bodies is too debilitating, and the length of the...
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...Assessment Health Assessment Questions 1. Health promotion a. What do you do to improve or maintain your health? b. What do you know about the links between lifestyle choices and health? 2. Nutrition a. Do you have any diseases that effects food choices? b. Do you consider yourself well nourished? 3. Sleep and Rest c. Describe your sleep wake cycle? d. Does this person appear physically relaxed and rested? 4. Elimination a. Do you have any disease of the digestive system, urinary system or skin? b. Are your excretory functions within the normal range? 5. Activity and Exercise a. Do you have trouble completing activities of daily living? b. How do you describe your weekly pattern of exercise and relaxation? 6. Cognitive/Perceptual a. How educated is this person? b. Do you have any diseases that effects the mental/sensory functions? 7. Self-Perception/Self-Concept a. Are you comfortable with your body image? b. Can you describe your state of mind? 8. Role Relationship a. How would you describe you various roles in life? b. Which relationships are most important to you at the present? 9. Sexuality a. Are you satisfied with your situation related to sexuality? b. Are you having any difficulties with your sexual functioning? 10. Coping/Stress Tolerance a. How do you handle stressful situations? b. Do these actions make the situation better or worse? 11. Values/Beliefs ...
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...Period | Location | Compliance % | Pain Reassessment | 12 Months | ED | 54.83% | Pain Reassessment | 12 Months | 3E | 92.916% | Pain Reassessment | 12 Months | PACU | 93.5% | The following are the results of the audit that was completed for use of prohibited abbreviations in an aggregate of ICU, Telemetry, 3E and 4E over a 12 month period: Audit | Audit Period | Abbreviation | Occurrences per 50 opportunities | Prohibited Abbreviations | 12 Months | “cc” | 33.75 | Prohibited Abbreviations | 12 Months | “qd” | 15.916 | Fire Dill History of drills held once per shift per quarter over a 12 month period: Quarter | Shift 1 | Shift 2 | Shift 3 | Compliance Analysis | 1st (Jan-Mar) | √ | √ | | No Fire drills on the 3rd shift | 2nd (Apr-Jun) | √ | √ | √ | 100% | 3rd (Jul-Sept) | √ | √ | | No Fire drills on the 3rd shift | 4th (Oct-Dec) | √ | | √ | No Fire drills on the 2nd shift | Below are the results from audit that was completed for verbal orders authenticated within 48 hours over a 12 month period (monthly and quarterly) for NIGHTINGALE COMMUNITY HOSPITAL:...
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...Business Case Analysis - Nursing Second Shift Staffing Business Case Analysis - Second Shift Staffing Monarch General Hospital has recently experienced short staffing of the nursing workforce for the second shift (15:30 to 23:30). This report was commissioned to examine options for the Healthcare Chief Officers involved, which will provide valuable guidance toward a reliable business solution based on currently available evidence. Background Monarch is currently experiencing a deficit in the supply of nurses. In particular, the deficit is on the second shift. But, overall, the actual problem to address is a less than optimal supply of nurses. The plan to remedy the problem for the actual shift involved will be addressed in the strategy and implementation. This deficit of nurses will cause delayed delivery of care to patients and/or adverse events. This will likely lead to patient dissatisfaction, lawsuits and the hospital absorbing unnecessary and unplanned for costs. These factors will ultimately lead to a reduced number of hospital admissions. Monarch must achieve the ability to control the shortage instead of surrendering to it. This report will examine two of the four currently considered options. The first option is hiring additional permanent personnel and the second is hiring short-term, temporary personnel to be used on an as needed basis. Business and Operational Impacts The factors leading to a reduced numbers of hospital admissions will affect...
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...Abstract This paper will explore the topic of nursing overtime and its effect on adverse events and errors in the workplace. The prevalence of mandatory and voluntary overtime is high. Nursing shortages combined with the aging baby boomer population means more work for health care workers, and nurses bear the brunt of this reality. There is some legislation in place to restrict mandatory overtime, but research suggests that overtime hours have not decreased since those policies were created. Furthermore, voluntary overtime is unregulated, with many nurses exceeding the recommended 40-hour workweek. Studies have shown that exceeding recommended hours results in workplace injuries to nurses, increased burnout and lower retention of nurses, and poorer outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s...
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...documentation shows that the master alarm panel for medical gasses was not tested annually per policy. This is a policy written by the hospital that is not being met. They are to follow the policies that they set for themselves. The Fire Drill History Report showed that the fire drill process is not adequate and does not meet standards. Quarterly fire drills are to be conducted as regulated by the Life Safety Code (TJC, 2013). Clutter was found in the hallways of 3E, 4E, OR and telemetry this could restrict people from leaving the floor safely in case of fire or smoke. Accreditations function of Nursing Leadership it was discovered that Nurses on 3E were not documenting in a timely manner. When questioned they responded that they were “too busy”. Resulting in overtime and low morale on the unit causing discussion about staffing, staffing patterns and nurse to patient ratio. This is all established in a guideline for delivery of nursing care, treatment, and services (TJC, 3013). Accreditation function of...
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...Bedside Report: Improving hand-off Shift Report in Hospital Settings Eastern International College Evelyn Terreros & Meron Gebrezgi April 26, 2013 End of shift reports between nurses has been an important process in clinical nursing practice. Allowing nurses to exchange vital patient information to ensure continuity of care and patient safety. Therefore, the chance of potential communication gaps causing an error is high. According to the Joint Commission, communication is the primary cause of medical errors, with handoffs accounting for 80% of these errors [ (Zhani, 2012) ]. The most commonly practiced model of report takes place in the staff room, at the nurses’ station, or other locations away from the patient’s bedside. However, more institutions are implementing the Bedside Report hand-off model to communicate patient care information. Research articles has identified the benefits of bedside report in conjunction with structured reporting tool (e.g. SBAR) as: (1) improvements in patient-centered care and nursing services, (2) less chance of medical errors, (3) decreasing the length of stay in patients [ (Chaboyer W, 2009) ]. Upon observing the shift to shift report in SMMC, it was evident that some nurses failed to provide effective communication and did not utilized the SBAR format tool as stated in the hospital’s guidelines. Hand-off reports were being done in the nurse’s station and along the unit’s hallways. Fatigue and...
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...in today (ER) because he is just not getting any better.” Mrs. C. also said that her husband has vomited, over the last 2 days. R.’s chief complaint (c/c) is abdominal pain, voiding frequently, and hasn’t been taking insulin due to nausea. Vital signs (RR) 32, and oxygen saturation (SAO2) 95%. He is alert & orientated (A&O) A&O x 1 (oriented only to person), and his mouth and mucous membranes are very dry. Doctor’s Orders: After seeing Mr. C. the doctor orders: CBC, Chem Panel, Electrolytes, UA with ketones, ABG, 12 lead EKG, and sliding scale insulin to be given IVP, oxygen at 2L/min per nasal cannula, and IV bolus of 500 cc/NS. After initiating a peripheral IV catheter, blood samples are drawn for labs and the nurse administers the 500 cc/NS and rechecked VS: Temperature (T) 100.3, P-106, BP-92/56, and RR-28. Labs The labs return with blood glucose of 625, K+5.3, bicarb (HCO3) 8 mEq/l, large amounts of ketones in urine and serum. ABG of pH-7.19, PO2-89, CO2-25, and HCO3-15. EKG The EKG is noted for tented T waves. Based off above initial findings, R. has hallmark signs and symptoms (s/s) of Diabetic Ketoacidosis (DKA) which include polyuria, gastrointestinal (GI) upset/abdominal pain, dehydration, orthostatic hypotension, bradypnea with deep respirations, also known as “Kusssmaul breathing.” Also, patient’s breath is acetone which is commonly interpreted as “fruity” and can be...
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...home. A lot of today's nurses are filling this need between the patient’s home and the hospital health care team. This trend continues to grow. Due to shorter hospital stay of patients, multiple skilled nurses and advanced technology, many changes will be impacted in Nursing in the year 2020. Some of these changes that will be made in the year 2020 are the following: 1. A shift from hospital to specialty care nursIng. 2. A shift to facing increasingly complex ethical dilemmas 3. A shift from working as a part of a hospital staff to "Dejobbing". Hospital opportunities will continue to rise in specialty areas. Due to advanced technology, critical care nurses will stay in demand to treat patients for conditions that previously would have been fata1. Other specialty areas would continue to be in demand such as preoperative, neurological, emergency and cardiovascular areas. Maternal/child health is another good choice for future nursing. The - .. , the sub specialties of Neonatal Intensive care and Pediatric Oncology continue to grow (Greene 192-208). Other good choices for future nursing are case and care management. Case management focuses on entire populations, not only on single patients. Care teams target population based on disease or need (e.g. prevention and education) and team members (nurses, dieticians, doctors) use critical judgement to benchmark data and analysis. Nurses will...
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