Download - Final Nap Presentation
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Introduction
Night shift work is associated with physical and mental affects.
-decreased reaction times
-decreased cognition
-physical and mental exhaustion
Placing the care of the patient and the nurse at risk for adverse
events.
This has resulted in many professional organizations to take a
stand, endorse and promote fatigue countermeasures such as a
nap on the night shift to promote patient and nurse safety.
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PurposeThrough synthesis and critical evaluation of the qualitative andquantitative evidence, assess the strength of evidence to
promote a practice change of instituting a nap during a night
shiftTerms
- a phenomenon that occurs in the circadiancycle that causes a dip in alertness causing fatigue and
sleepiness, occurs around 1500-1600 and 0400-0600
- the feeling of fatigue that is felt immediately after
waking usually lasting < 1 hour, is affected if waking close toNadir phenomenon
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Most research states that the timing of the nap is
crucial to lessen effects of sleep inertia upon waking.
Synthesizing the research a nap of about 30-minutes
around the time of 0200-0330 is the most beneficial.
One study was disregarded due to the finding of a 2-3hour nap on a 12-hour night shift is not realistic.
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Environment was noted as one of the barriers to
napping.
There were 2 differences noted in environments.
1. Nap environment
2. Unit environment
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The impact of a nap-feeling restored or fatigued.
In some of the studies subjects subjectively reported no
improvement in fatigue, in contrast objectively based on motortest improve reaction times were noted
In contrast a few of the studies found no difference between
subjective and objective sleepiness.
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Sampling
-mix of sampling in studies, this was noted as a
limitation to the research
Designs and Methods
-mix of qualitative and quantitative designs
-healthcare-most are qualitative
-there were a couple of RCT studies, Correlational,
Retrospective, Prospective, and Quasi-Experimental
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Instruments and Data Collection
-quantitative studies consisted of computerized
cognitive and motor tests
-qualitative studies, most consisted of
questionnaires, interviews and focus groups
In summary very few provided full descriptions
of instruments and data collection, this was
noted as a limitation.
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Results and Statistical Analysis
-all the studies presented the findings and
analysis comprehensively
-the to all the studies this was the strength
noted to the research
-a couple studies discussed the findings related
to inconsistent with previous research
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Emerging Gaps
-Rotating shift workers vs. Straight nights
-in correlation to rotating, the aging population of
nursing-the use of caffeine and a nap together-studiesprohibited the use of caffeine during experimentalperiod
-fatigue across all shifts-Environment of different units have differentdemands
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The biggest barrier is culture!!!!!!!
In the questionnaires of reason for not napping, responses such
as; feeling guilty, not comfortable leaving patients, inadequate
staffing, unit busy, and uncomfortable nap environment.
This is the reason in is not a practice standard, though supported
by theAmerican Association of Critical Care Nurses, AmericanCollege of Critical Care Medicine, American Nurses Credentialing
Center-Magnet, and Joint Commission, just to name a few.
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The summary of the evidence it is proven that ashort nap on a night shift is beneficial to counteractfatigue and sleepiness.
There is a need for further research involving thenursing profession to optimize its utilization.
I think further research into rotating shifts and allshifts related to fatigue and countermeasure toaddress these issues as needed.
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