八小时轮班护士工作时间警觉性：一项观察性研究

Abstract

 Purpose

The aim of this study was to identify the patterns of the decline in the alertness of rotating-shift nurses during working hours across different shift types (day, evening, and night) using an objective measure.

Design

An observational study using ReadiBand wrist actigraphs was conducted.

Methods

Data were collected from June 2019 to February 2020. Participants were rotating-shift nurses (N = 82) who provided direct nursing care for patients in acute care hospitals in South Korea. Nurses wore actigraphs continuously for 14 days on their non-dominant hand to identify sleep–wake cycles and predict their alertness scores hourly. All participants completed a sleep diary.

Findings

Nurses working during night shifts had lower average alertness scores (mean = 77.12) than nurses working during day (mean = 79.05) and evening (mean = 91.21). Overall, alertness showed a declining trend and the specific patterns of decline differed across shifts. Participants with alertness scores less than 70 or 80 demonstrated a significant decline in alertness across all shifts.

Conclusions

Distinct patterns of decline in alertness per nursing shift were revealed. Each shift feature should be considered when developing interventions to increase nurses’ alertness, promote high-quality care provision, and ensure patient safety.

Clinical relevance

The implementation of interventions to increase alertness among shift nurses is needed at the organizational level, and the cooperation of nursing managers and administrators is required.

摘要翻译（仅供参考）

目的

本研究的目的是利用客观的测量方法确定不同班次（白天、晚上和夜间）的轮班护士在工作时间内警觉性下降的模式。

设计

使用ReadiBand腕部测功仪进行观察性研究。

方法

数据收集于2019年6月至2020年2月。参与者是轮班护士（N = 82），他们在韩国的急诊医院为患者提供直接护理。护士们在14天内连续在他们的非优势手掌上佩戴测功仪，以确定睡眠-觉醒周期并每小时预测他们的警觉性得分。所有参与者都填写了睡眠日记。

研究结果

上夜班的护士的平均警觉性得分（平均=77.12）低于白天（平均=79.05）和晚上（平均=91.21）的护士。总的来说，警觉性呈下降趋势，不同班次的具体下降模式也不同。警觉性得分低于70或80分的参与者在所有班次中都表现出显著的警觉性下降。

结论

每个护理班次的警觉性下降的模式是不同的。在制定干预措施以提高护士的警觉性、促进高质量的护理服务并确保患者安全时，应考虑每个班次的特点。

临床意义

需要在组织层面实施干预措施，以提高轮班护士的警觉性，并需要护理管理者和行政人员的合作。

原文链接：

https://doi.org/10.1111/jnu.12743

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