Daytime sleepiness, sleep habits and occupational accidents among hospital nurses

AIM: This paper reports a study to determine the prevalence of excessive daytime sleepiness and sleep habits among hospital nurses and to analyse associations between excessive daytime sleepiness and different types of medical error. BACKGROUND: It has been reported that sleep disorders, and the tiredness and sleepiness brought about by sleep disorders may be associated with occupational accidents. However, to our knowledge, there has so far been no report on associations between sleep disorders, excessive daytime sleepiness in particular, and occupational accidents among hospital nurses. METHODS: The study was a cross-sectional study targeting 4407 nurses working in eight large general hospitals in Japan. An anonymous self-administered questionnaire was used to investigate their sleep patterns and experience of occupational accidents. The data were collected in 2003. RESULTS: The prevalence of excessive daytime sleepiness among hospital nurses in the present study was 26.0%. A statistically significant relationship was observed between having or not having occupational accidents during the past 12 months and excessive daytime sleepiness. Multiple logistic regression analyses on factors leading to occupational accidents during the past 12 months showed statistically significant associations between (1) drug administration errors and (2) shift work and age, between (1) incorrect operation of medical equipment and (2) excessive daytime sleepiness and age, and between needlestick injuries and age. CONCLUSIONS: Excessive daytime sleepiness is an important occupational health issue in hospital nurses. It is possible that occupational policies and health promotion measures, such as a provision of sleep hygiene advice and social support at worksites, would be effective in preventing occupational accidents among hospital nurses.     

Nurses,Smoking, and Immunity: A Review

Nurses regularly are exposed to a variety of occupational hazards. In addition to documented occupational hazards, exposure to smoking remains a major concern. This article reviews the prevalence of smoking among nurses working in the United States and discusses their reasons for smoking. Researchers conducted a state‐of‐the‐art review on the effects of cigarette smoking and exposure to secondhand smoke (SHS) on the immune system. Smoking prevalence among nurses working in the United States ranged from 7%–12%, and high work stress, poor work environment, shift work, and peer influence were suspected major risk factors influencing smoking behavior. A review of the effects of smoking on immunity revealed that both active smoking and exposure to SHS negatively affects immune function. When rehabilitation nurses stop smoking, their health improves and nonsmokers are exposed to less SHS. Rehabilitation nurses are encouraged to share knowledge of the immunological benefits of smoking cessation with patients to facilitate nurse‐led rehabilitation programs.     

Effect of psychosocial factors on metabolic syndrome in male and female blue‐collar workers

Aim: The purposes of this study were to examine the relationship between psychosocial factors and metabolic syndrome among male and female blue‐collar workers, and which factors influence their metabolic syndrome by sex. Methods: A cross‐sectional study was completed of 154 men and 80 women working at small companies in Korea. The data were collected through a structured questionnaire, blood test, and anthropometric and blood pressure measure. Metabolic syndrome was diagnosed from the results of blood test and the measurements of waist circumference and blood pressure. Results: The prevalence of metabolic syndrome among male and female blue‐collar workers was 24.0% and 7.5%, respectively. Multiple logistic regression analysis was performed to examine factors of metabolic syndrome associated with sex. After controlling for age, marital status, smoking, alcohol drinking, shift work, overtime work, and physical exercise, job stress (odds ratio [OR] = 3.10, P = 0.005) and risk perception (OR = 1.12, P = 0.016) were influencing factors for men, and low job stress (OR = 0.05, P = 0.04), low social support (OR = 1.51, P = 0.009), and risk perception (OR = 1.27, P = 0.023) for women. Conclusion: Metabolic syndrome among blue‐collar workers is closely related to psychosocial factors, such as job stress, social support, and risk perception, with the effect of job stress a point of difference between men and women. Occupational health nurses should be cognizant of the importance of assessing the effect of psychosocial factors on cardiovascular risk for blue‐collar workers.     

Intention to receive the seasonal influenza vaccine among nurses working in a long‐term care facility

The factors affecting influenza vaccine uptake among nurses might vary between different medical facilities. The purpose of the present study was to explore factors that affect the intention of nurses at a long‐term care facility to receive the influenza vaccine and whether the health belief model predicts this intention. In this cross‐sectional quantitative correlational study, a convenience sample of 150 nurses employed at a large long‐term care facility in central Israel completed a questionnaire based on the health belief model. Data collection took place between January and February of 2016. Forty‐two percent of the respondents reported having been vaccinated against influenza in the current year. The health belief model explained 53% of the variance (p < .01), with perceived (personal) benefits of the vaccine being the most significant factor. The number of times of receiving the influenza vaccine in the past was strongly correlated with the intention to receive the vaccine (p < .01). To improve nurses' compliance with influenza vaccination at long‐term care facilities, we find that it is necessary to emphasize the benefits of vaccination and, particularly, the personal benefits. Annual vaccination behavior should be promoted to make it become a routine.     

Physically restraining elder residents of long‐term care facilities from a nurses' perspective

Ben Natan M, Akrish O, Zaltkina B, Noy RH. International Journal of Nursing Practice 2010; 16 : 499–507
Physically restraining elder residents of long‐term care facilities from a nurses' perspective The purpose of the current study was to identify and analyse major variables affecting intended decisions of nursing staff to physically restrain elder residents of long‐term care facilities. The study explored whether a research model constructed of staff characteristics and resident characteristics would prove useful for predicting behavioural intentions. A total of 120 reliable and validated questionnaires, based on the research model, were administered to nurses working in a large long‐term care facility for older adults in central Israel; 104 questionnaires were returned for a response rate of 86%. The research findings indicate that most of the nurses who responded (67.2%) reported that they had physically restrained elder residents more than 10 times over the past year; however, the nurses had a low intention of restraining residents during the coming year. The research results indicate that the intended decision of nursing staff to restrain elderly residents is a derivative of their behavioural beliefs and attitudes, normative beliefs and subjective norms, as well as of residents' dementia, physical state and stress.     

Explaining the national differences in pressure ulcer prevalence between the Netherlands and Germany – adjusted for personal risk factors and institutional quality indicators

Background Pressure ulcers have a known impact on quality of life as well as on morbidity and mortality of the persons affected. Remarkable differences in pressure ulcer prevalence between the Netherlands and Germany have been found during the last 6 years. This study explores to what extent the individual risk of the population and quality indicators of the institutions can explain the variation in national prevalence. Methods Data of a binational multi‐centred cross‐sectional study in 103 hospitals (n = 21 378 patients) and 129 nursing homes (n = 15 579 residents) were analysed using random effects regression models to calculate the differences in national prevalences within the nursing homes and hospitals, adjusted for personal risk for pressure ulcer and quality indicators. Results The prevalence of pressure ulcers among the at‐risk group (Bradenscore ≤20) in nursing homes was 30.8% in the Netherlands and 8.3% in Germany [OR: 4.9 (CI 95%: 4.2–5.7)]. In hospitals, the prevalence among the at‐risk group was 26.1% in the Netherlands and 21.2% in Germany [OR: 1.3 (CI 95%: 1.2–1.5)]. After adjusting for individual risk factors (age, gender, Bradenscore) as well as for quality structures (use of prevention and treatment protocols, experts groups, information leaflets, nurses training, central pressure ulcer statistics and regular updating of protocols), the chance of developing a pressure ulcer was 6.05 times higher (CI 95%: 4.0–9.2) in a Dutch nursing home than in a German nursing home. Within the hospitals, the OR for Dutch patients was 2.03 (CI 95%: 1.4–3.0). Conclusion A remarkable national variation exists in pressure ulcer prevalence and nursing practice. Neither the populations vulnerability for pressure ulcers nor pressure ulcer management as measured in this study could explain this national variation. Therefore, other risk factors should be taken into consideration. Additionally, it is possible that quality indicators are implemented in differing ways with varying levels of effectiveness. Therefore, further research is needed to examine prospectively and in more detail the reality of care within facilities in both countries.     

Low back pain: prevalence and associated risk factors among hospital staff

Title. Low back pain: prevalence and associated risk factors among hospital staff. Aim. This paper is a report of a study conducted to describe the prevalence and risk factors for lower back pain amongst a variety of Turkish hospital workers including nurses, physicians, physical therapists, technicians, secretaries and hospital aides. Background. Hospital workers experience more low back pain than many other groups, the incidence varies among countries. Work activities involving bending, twisting, frequent heavy lifting, awkward static posture and psychological stress are regarded as causal factors for many back injuries. Method. A 44‐item questionnaire was completed by 1600 employees in six hospitals associated with one Turkish university using a cross‐sectional survey design. Data were collected over nine months from December 2005 to August 2006 and analysed using Chi square and multivariate logistic regression techniques. Findings. Most respondents (65·8%) had experienced low back pain, with 61·3% reporting an occurrence within the last 12 months. The highest prevalence was reported by nurses (77·1%) and the lowest amongst secretaries (54·1%) and hospital aides (53·5%). In the majority of cases (78·3%), low back pain began after respondents started working in the hospital, 33·3% of respondents seeking medical care for ‘moderate’ low back pain while 53·8% (n = 143) had been diagnosed with a herniated lumbar disc. Age, female gender, smoking, occupation, perceived work stress and heavy lifting were statistically significant risk‐factors when multivariate logistic regression techniques were conducted (P < 0·05). Conclusion. Preventive measures should be taken to reduce the risk of lower back pain, such as arranging proper rest periods, educational programmes to teach the proper use of body mechanics and smoking cessation programmes.     

Condom promotion in Belize: self-efficacy of Belizean nurses

NASH W.A. (2011) Condom promotion in Belize: self‐efficacy of Belizean nurses. International Nursing Review 58 , 477–483 Background: Outside of abstinence, correct and consistent condom use is the single most effective tool to prevent the transmission human immunodeficiency virus (HIV). This is particularly true in countries such as Belize where incidence rates remain high. Women are physiologically at higher risk for HIV, and many feel powerless to insist on condom use. Although nurses are in a position to promote condom use, variables that influence this decision are not clearly understood. In this study, we examined variables that influence a nurses' self‐efficacy to promote and teach condom use to women specifically to reduce their HIV risk. Methods: Data related to self‐efficacy, vicarious experience related to condom use promotion and a nurse's sexual relationship power were collected from nurses practising in Belize (n = 60). These data were cross‐sectional and collected at the annual nurses' conference. Results: Both years of nursing education and positive vicarious experience promoting and teaching condom use to women were positively correlated to their self‐efficacy to do so. Vicarious experience was significantly correlated to self‐efficacy in a subgroup of nurses with lower sexual relationship power but not in those with higher sexual relationship power. Conclusions: When designing HIV continuing education programmes for nurses in Belize, it is important to consider level of nursing education and access to vicarious experience such as mentoring and role modelling. An additional factor to consider is the influence that a nurse's power in her own primary sexual relationship may play in the formation of her self‐efficacy.     

Work-related stress, education and work ability among hospital nurses

Title. Work‐related stress, education and work ability among hospital nurses. Aim. This paper is a report of a study conducted to determine which occupational stressors are present in nurses’ working environment; to describe and compare occupational stress between two educational groups of nurses; to estimate which stressors and to what extent predict nurses’ work ability; and to determine if educational level predicts nurses’ work ability. Background. Nurses’ occupational stress adversely affects their health and nursing quality. Higher educational level has been shown to have positive effects on the preservation of good work ability. Method. A cross‐sectional study was conducted in 2006–2007. Questionnaires were distributed to a convenience sample of 1392 (59%) nurses employed at four university hospitals in Croatia (n = 2364). The response rate was 78% (n = 1086). Data were collected using the Occupational Stress Assessment Questionnaire and Work Ability Index Questionnaire. Findings. We identified six major groups of occupational stressors: ‘Organization of work and financial issues’, ‘public criticism’, ‘hazards at workplace’, ‘interpersonal conflicts at workplace’, ‘shift work’ and ‘professional and intellectual demands’. Nurses with secondary school qualifications perceived Hazards at workplace and Shift work as statistically significantly more stressful than nurses a with college degree. Predictors statistically significantly related with low work ability were: Organization of work and financial issues (odds ratio = 1·69, 95% confidence interval 1·22–2·36), lower educational level (odds ratio = 1·69, 95% confidence interval 1·22–2·36) and older age (odds ratio = 1·07, 95% confidence interval 1·05–1·09). Conclusion. Hospital managers should develop strategies to address and improve the quality of working conditions for nurses in Croatian hospitals. Providing educational and career prospects can contribute to decreasing nurses’ occupational stress levels, thus maintaining their work ability.     

The effects of aromatherapy in relieving symptoms related to job stress among nurses

Workplace‐related stress has become today's most serious occupational hazard. Aromatherapy is a simple, convenient and non‐invasive method of stress relief. There is little research regarding the efficacy of aromatherapy by means of inhaling essential oil in reducing workplace stress‐related symptoms among nurses. Therefore, this study was to examine the effectiveness of lavender oil inhalation in reducing job stress‐related symptoms among nurses. The 53 nurses in the experimental group pinned small bottles containing 3% lavender oil on the clothes of their right chests, whereas 57 participants in the control group pinned bottles with no lavender oil. Aromatherapy was shown to be effective in the reduction of the number of stress symptoms for 3 or 4 days. The stress symptoms of the experimental group decreased from 6.1 to 2.8 after aromatherapy was carried out (P = 0.126, 0.159, 0.035 and 0.026). This represented a significant decrease in stress, whereas the stress symptoms in the control group increased from 5.6 to 5.8. Hospital staff managers are still encouraged to include aromatherapy concepts and techniques in the continuing education of nursing staff. Concurrently, future research should focus on the possible side effects of aromatherapy to assure safety.     

Factors that predict the post-discharge use of recommended assistive technology (AT)

Purpose.?This study investigated the ability of client-, assistive technology (AT)- and intervention-related factors to predict the post-discharge use of rails and bathing, toileting and dressing AT, which had been recommended by an occupational therapist during hospitalisation.

Method.?A prospective correlational study involving interviews conducted pre and post discharge for those clients who required rails and bathing, toileting and dressing AT was used. Additionally, a direct logistic regression analysis with backwards elimination was performed to identify predictor variables.

Results.?Variables found to predict AT use included participants' perceptions of the characteristics of the AT, the presence or absence of anxiety, and their ability to recall AT training. Additionally four other variables (intended post-discharge use of AT, negative perceptions about disability/illness, perceived benefit of the AT and having a choice during the AT selection process) were strongly related to AT use. Although these four variables were not included in the best final model they are nevertheless important and need to be considered when recommending AT.

Conclusions.?The findings suggest that occupational therapists need to ensure that AT is recommended using a client-centred approach, where clients' perceptions and opinions are considered along with their needs and goals. The Matching Person to Technology (MPT) Model is suggested as a useful framework to guide the process of recommending AT.     

手术室护士职业性肌肉骨骼损伤状况及其影响因素分析

目的探讨手术室护士职业性肌肉骨骼损伤（occupationalmusculoskeletalinjury,OMSI）状况及其影响因素。方法采用便利取样法,选取深圳某3家二级甲等综合医院与5家三级甲等综合医院手术室护士300名,对其OMSI状况及其影响因素进行调查分析。结果手术室护士OMSI首发年龄（31．6±6．8）岁,患病率81．3％,其中背部、腰部、肩部损伤患病率最高。年龄大、工龄长、超重、工作中休息不足、工作中缺少肌肉放松和锻炼的提示、岗位轮转少及每周工作时问的手术室护士OMSI患病率较高（均P〈0．01）。结论手术室护士OMSI患病率较高,除与年龄、工龄、身体质量指数（bodymassidex,BMI）相关外,职业危险因素和职业管理因素也是影响其发生发展的重要方面。     

Commuting patterns among Italian nurses: a cross-sectional study

FESTINI F., CIOFI D. & BISOGNI S. (2011) Commuting patterns among Italian nurses: a cross‐sectional study. International Nursing Review 58 , 354–360 Commuting is an additional burden that affects working stress, reduces leisure time and raises the risk of accidents. Little data are available about nurses' commuting patterns or the impact of commuting on their lives. Objectives: The study aims to describe commuting patterns among Italian nurses and to explore possible associations with nurses' intention to change job. Methods: This is a cross‐sectional study carried out in central Italy. Nurses were invited to participate through a variety of public measures. Those participating completed an online questionnaire available on a website established for this specific purpose. Results: Five hundred sixty‐five nurses participated. The mean distance covered every day to go to work and back home is 30.8 km. A total of 43.3% of nurses cover 25 km or more every day to work; 5.7% cover 100 km or more. The mean time spent in commuting is 52.9 min daily. Furthermore, 14.5% of nurses spend every month commuting a time equal to or longer than the working time of 1 week. The mean monthly expenditure is 87.30 Euro (6% of mean salary). Nurses younger than 30 cover longer distances (P = 0.0006), spend more time (P = 0.001) and have higher expenditure (P = 0.003) than their older colleagues. Willingness to change job seems associated with the use of public means of transportation (P = 0.04). Nurses from the population under study cover longer distances, spend longer time in daily commuting and have higher monthly costs than the rest of the Italian workers' population. Conclusions: Travelling to work represents a non‐negligible burden for nurses, particularly for younger nurses. Nurses seem to have lesser opportunities to rest and to recover energies than other workers. The Italian nurses' recruiting system may have a role in explaining our data. Further studies are needed to investigate the impact of nurses' commuting on the healthcare system.