Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Abstract, Hypothesis, and Purpose of the Study
Fatigue is associated with mental or physical exertion and is often caused by repeated stress variations. The hypothesis of this study is monitoring changes in fatigue and sleep is important to enable effective fatigue management. Fatigue levels and sleep patterns are important determinants of nurses’ work output. Nonetheless, excessive work, insufficient recovery, a hectic work environment, and disrupted sleep patterns are the major causes of fatigue due to the overall stress effect they cause on the nurses (Cho et al., 2021). The fatigue levels vary across periods and shifts, as seen in the study. The study aims to investigate nurses’ fatigue levels and sleep measures during two 12-hour consecutive day shifts and assess the nurses’ fatigue levels within shifts and their previous-night sleep characteristics. This investigation brought out the factors influencing the fatigue levels in hospital nurses. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Study design, Weakness, and Strength
The study design employed for this study was a descriptive, repeated measures study design. It included self-reported measures of fatigue together with objective and subjective sleep measures (Cho et al., 2021). The study was conducted from April 2017 through May 2017 and from September 2018 through January 2019. This study design was, therefore, appropriate for the study because it allowed the subjects to be measured two or more times on the dependent variable and under different conditions. For instance, fatigue levels were measured approximately every 4 hours, starting at T1 at 7 AM, followed by T2 at 11 AM, T3 at 3 PM, and finally T4 at the end of the day shift at around 7:30 PM.
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The strengths of the design include the reduction of participant variables since the same subjects, that is, the 29 selected registered nurses, were used throughout the study. In addition, the small sample size of 29 participants needed to take part in all conditions ensured that the study was time-saving. The study design also enabled measurements to be conducted twice or more than twice. On the other hand, the study design also has notable weaknesses. For instance, the sample size was small and could not accurately represent the total direct care registered nurse (RN) population.
Sampling Method, Inclusion, and Exclusion Criteria
In sampling, a predetermined number of observations is obtained from a larger population. A purposive sampling technique was employed to obtain the desired sample size of 29 nurses in the study. The purposive sampling technique purposefully selects subjects based on the desired characteristics, conditions, and their ability to provide in-depth information on the phenomena under investigation (Vigoureux & Lee, 2021). This technique proved to be appropriate as it enabled the purposeful selection of nurses who worked two consecutive 12-hour shifts drawn across three general care medical/surgical inpatient units. Day shifts were purposefully selected as previous research indicated higher fatigue levels in day shift nurses (Cho et al., 2021). In addition to day shift selection, 12-hour shifts were selected as they were the most commonly scheduled in the study units. All these selection criteria were purposefully aimed at obtaining information on the fatigue levels and sleep measures of hospital nurses during the 12-hour shift. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Based on the inclusion and exclusion criteria, nurses who worked 2 consecutive 12-hour day shifts following at least 24 hours off were included in the study. This is because they satisfactorily met the inclusion criteria. The exclusion criterion for the study was night shifts, as the study purposefully aimed at investigating fatigue levels in day shift nurses, considering that previous research has indicated the fatigue levels to be higher in day shift nurses compared to those in night shift nurses.
Study Tools
The tools for data collection and analysis are selected based on factors such as the phenomenon under study and the type of information needed from the study. The validity and reliability of these tools go a long way in ensuring the credibility of the study (Vigoureux & Lee, 2021). This is important as a credible study provides valid information. The flyers posted on each unit conveyed the recruitment message to the target population and enhanced the subject recruitment, thus proving to be reliable since they conveyed the same message in all the units. Furthermore, the Actiwatch Spectrum PRO used to collect sleep data was valid. Considering that it is worn around the wrist and carries out a constant and accurate measurement of sleep, its validation proved to be strong. In the measurement of fatigue levels, the tools, the Brief Fatigue Inventory (BFI) and the Swedish Occupational Fatigue Inventory (SOFI) were considered valid as they have been reported to be accurate and reliable. With scales on both BFI and SOFI, deductions on fatigue levels could be made. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Data Analysis
Data analysis is one of the essential undertakings in a study process. It involves preparing the raw data collected to obtain meaningful information from it. The data analysis process is carried out using various techniques depending on the data to be analyzed. In the study, the data analysis process involved the calculation of minimum and maximum values and means with standard deviations. The fatigue levels and the sleep measures were obtained by calculating the area under the curve using the trapezoid formula.
Study Findings
The specific findings of the study show that in approximately 47% of the shifts for which the data was collected, nurses left work after the designated time for the end of the shift (Cho et al., 2021). It is also evident that fatigue levels were highest at or during the end of the shift. These could be accounted for by the exhaustion due to the workload and insufficient time for recovery. As noted, there was a significant increase in subjective sleep quality on the night before the second shift than on the night before the first shift. Furthermore, the likelihood of nurses being injured is more at the later shift hours, probably due to the increased fatigue levels. Another notable finding is that fatigue accumulates over consecutive shifts. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Application of Study in Nursing.
This study offers the application and implementation of helpful ideologies for nursing. For instance, monitoring programs that regularly measure nurses’ fatigue levels can be initiated to capture these dynamic changes (Cho et al., 2022). The study also provides essential insights to control the development of countermeasures for managing nurse fatigue during shifts, such as introducing strategic rest breaks to enhance recovery, albeit short-term (Cochran et al., 2021). These applications help improve nurses’ work efficiency together with their well-being and that of the patients.
Limitations
Research limitations arise from the chosen research study design or the methodology used. From the study, some limitations could be noted. Consequently, these limitations could result in certain information being left out. The study was done in one hospital setting with a sample size of 29 registered nurses. This sample size was small and could not be a true representation of the total nurse population in the hospital. In addition, the fact that it was conducted in one hospital setting does not truly reflect the settings in other hospitals (Cochran et al., 2021). With a focus only on nurses working 12-hour day shifts and in medical/surgical units, the study left out nurses working night shifts and in other units who could also have important inputs on the fatigue levels and sleep measures. Therefore, it was not comprehensive. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
Ethical Considerations
The study subjects were ethically managed as various ethical principles were applied during the study. For instance, the principle of beneficence was employed in the study to investigate the fatigue levels and sleep measures among the nurses and eventually propose effective measures to counter fatigue and benefit the nurses (Cho et al., 2022). The principle was employed in the study by ensuring no harm was caused to the subjects in any way. Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
References
Cho, H., Brzozowski, S., Arsenault Knudsen, É. N., & Steege, L. M. (2021). Changes in fatigue levels and sleep measures of hospital nurses during two 12-hour work shifts. The Journal of Nursing Administration, 51(3), 128–134. https://doi.org/10.1097/NNA.0000000000000983
Cho, H., Sagherian, K., Scott, L. D., & Steege, L. M. (2022). Occupational fatigue, individualized nursing care, and quality of nursing care among hospital nurses. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.12768
Cochran, K. R., Letvak, S. A., McCoy, T. P., Bacon, C., & Karper, W. B. (2021). Can nurses self-assess fatigue?: Implications for nurse leaders. The Journal of Nursing Administration, 51(10), 507–512. https://doi.org/10.1097/nna.0000000000001055
Vigoureux, T. F. D., & Lee, S. (2021). Individual and joint associations of daily sleep and stress with daily well-being in hospital nurses: an ecological momentary assessment and actigraphy study. Journal of Behavioral Medicine, 44(3), 320–332. https://doi.org/10.1007/s10865-021-00207-z Article Review: Changes in Fatigue Levels and Sleep Measures of Hospital Nurses Essay
