Nurses' napping practices and their effects on sleepiness, fatigue, well-being, and quality of nursing care
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Abstract
Background & Aim: Napping is one of the evidence-based countermeasures to fatigue and decreased alertness during night shift work. We aimed to understand night shift nurses' napping practices and study the effectiveness of different nap lengths on sleepiness, fatigue, well-being, and the quality of nursing care.
Methods & Materials: A comparative descriptive design was used. Data were self-reported by 305 nurses using the Questionnaire on Night Shift Napping Practices, the Karolinska Sleepiness Scale, the Fatigue Visual Analog Scale, the Everyday Feeling Questionnaire, and the Quality of Nursing Care Questionnaire. Data collection was done over 4 months between August and November 2022. Frequency tables, Mean, and standard deviation were used to describe data, and One-way analysis of variance (ANOVA) was used for means comparisons.
Results: About 40% of the nurses reported that they took naps during their night shifts. The majority (82.92%) reported that they napped for more than 45 minutes (N= 305). Napping was found to significantly reduce sleepiness (P= 0.002) and fatigue (P= 0.001), and improve the quality of nursing care (P= 0.03). The group who napped for more than 45 minutes reported significantly reduced levels of sleepiness (P= 0.02) and fatigue (P= 0.01) when compared to the group who either didn’t nap or napped for less than 45 minutes.
Conclusion: This study suggests that implementing nap interventions for nurses on night shift can be an effective method to reduce sleepiness and fatigue, and improve patient care.
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10. Bonnefond A, Tassi P, Roge J, Muzet A. A critical review of techniques aiming at enhancing and sustaining worker's alertness during the night shift. Industrial Health. 2004;42(1):1-4.
11. Dalky HF, Raeda AF, Esraa AA. Nurse managers’ perception of night‐shift napping: A cross‐sectional survey. In Nursing Forum. 2018; 53(2): 173-78.
12. Faraut B, Andrillon T, Vecchierini MF, Leger D. Napping: a public health issue. From epidemiological to laboratory studies. Sleep Medicine Reviews. 2017 Oct 1;35:85-100.
13. Brooks A, Lack L. A brief afternoon nap following nocturnal sleep restriction: Which nap duration is most recuperative? Sleep. 2006 Jun 1;29(6):831-40.
14. Brown JG, Sagherian K, Zhu S, Wieroniey M, Blair L, Warren J, Hinds P, Szeles R. Napping on the night shift: A two-hospital implementation project. The American Journal of Nursing. 2016 May;116(5):26.
15. Joint Commission. Sentinel event alert: health care worker fatigue and patient safety. Sentinel Event Alerts: Joint Commission. 2011;48.
16. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007 May;39(2):175-91.
17. Gray JR., Grove SK, Sutherland S. The practice of nursing research: Conduct, Critique and Utilization, Fifth Ed. St. Louis, United; 2016.
18. Åkerstedt T. Sleepiness as a consequence of shift work. Sleep. 1988 Jan 1;11(1):17-34.
19. Monk TH. A visual analogue scale technique to measure global vigor and affect. Psychiatry Research. 1989 Jan 1;27(1):89-99.
20. Uher R, Goodman R. The everyday feeling questionnaire: the structure and validation of a measure of general psychological well-being and distress. Social Psychiatry and Psychiatric Epidemiology. 2010 Mar;45:413-23.
21. Han K, Hwang H, Lim E, Jung M, Lee J, Lim E, Lee S, Kim YH, Choi-Kwon S, Baek H. Scheduled naps to improve drowsiness and quality of nursing care among 12-hour shift nurses. International Journal of Environmental Research and Public Health. 2021 Feb;18(3):891.
22. Geiger Brown J, Wieroney M, Blair L, Zhu S, Warren J, Scharf SM, Hinds PS. Measuring subjective sleepiness at work in hospital nurses: Validation of a modified delivery format of the Karolinska Sleepiness Scale. Sleep and Breathing. 2014 Dec;18:731-9.
23. Martin-Gill C, Barger LK, Moore CG, Higgins JS, Teasley EM, Weiss PM, Condle JP, Flickinger KL, Coppler PJ, Sequeira DJ, Divecha AA. Effects of napping during shift work on sleepiness and performance in emergency medical services personnel and similar shift workers: A systematic review and meta-analysis. Prehospital emergency care. 2018 Feb 15;22(sup1):47-57.
24. Dinges DF. An overview of sleepiness and accidents. Journal of Sleep Research. 1995 Dec;4:4-14.
25. Davy J, Göbel M. The effects of a self-selected nap opportunity on the psychophysiological, performance and subjective measures during a simulated industrial night shift regimen. Ergonomics. 2013 Feb 1;56(2):220-34.
26. Barthe B, Tirilly G, Gentil C, Toupin C. Job demands and resting and napping opportunities for nurses during night shifts: Impact on sleepiness and self-evaluated quality of healthcare. Industrial Health. 2016;54(2):157-62.
27. Silva-Costa A, Araú MM, Nagai R, Fischer FM. Environmental and organizational conditions for napping during night work: A qualitative study among nursing professionals. Sleep Science. 2010;3(1):11-5.
28. Hilditch CJ, Dorrian J, Centofanti SA, Van Dongen HP, Banks S. Sleep inertia associated with a 10-min nap before the commute home following a night shift: A laboratory simulation study. Accident Analysis & Prevention. 2017 Feb 1;99:411-5.
2. Ferri P, Guadi M, Marcheselli L, Balduzzi S, Magnani D, Di Lorenzo R. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts. Risk management and healthcare policy. 2016 Sep 14:203-11.
3. Querstret D, O'Brien K, Skene DJ, Maben J. Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives. International Journal of Nursing Studies. 2020 Jun 1;106:103513.
4. Baron KG, Reid KJ. Circadian misalignment and health. International Review of Psychiatry. 2014 Apr 1;26(2):139-54.
5. Di Muzio M, Reda F, Diella G, Di Simone E, Novelli L, D’Atri A, Giannini A, De Gennaro L. Not only a problem of fatigue and sleepiness: changes in psychomotor performance in italian nurses across 8-h rapidly rotating shifts. Journal of Clinical Medicine. 2019 Jan 5;8(1):47.
6. Fabbian F, Zucchi B, De Giorgi A, Tiseo R, Boari B, Salmi R, Cappadona R, Gianesini G, Bassi E, Signani F, Raparelli V. Chronotype, gender and general health. Chronobiology International. 2016 Aug 8;33(7):863-82.
7. Hong YH. Napping and Errors in Night Shift Nursing. Depaul University. Available from: https://via.library.depaul.edu/nursing-colloquium/207/Summer_2017/13/ (accessed 5 October 2022)
8. Bae SH, Fabry D. Assessing the relationships between nurse work hours/overtime and nurse and patient outcomes: Systematic literature review. Nursing Outlook. 2014 Mar 1;62(2):138-56.
9. James L, James SM, Wilson M, Brown N, Dotson EJ, Edwards CD, Butterfield P. Sleep health and predicted cognitive effectiveness of nurses working 12-hour shifts: an observational study. International Journal of Nursing Studies. 2020 Dec 1;112:103667.
10. Bonnefond A, Tassi P, Roge J, Muzet A. A critical review of techniques aiming at enhancing and sustaining worker's alertness during the night shift. Industrial Health. 2004;42(1):1-4.
11. Dalky HF, Raeda AF, Esraa AA. Nurse managers’ perception of night‐shift napping: A cross‐sectional survey. In Nursing Forum. 2018; 53(2): 173-78.
12. Faraut B, Andrillon T, Vecchierini MF, Leger D. Napping: a public health issue. From epidemiological to laboratory studies. Sleep Medicine Reviews. 2017 Oct 1;35:85-100.
13. Brooks A, Lack L. A brief afternoon nap following nocturnal sleep restriction: Which nap duration is most recuperative? Sleep. 2006 Jun 1;29(6):831-40.
14. Brown JG, Sagherian K, Zhu S, Wieroniey M, Blair L, Warren J, Hinds P, Szeles R. Napping on the night shift: A two-hospital implementation project. The American Journal of Nursing. 2016 May;116(5):26.
15. Joint Commission. Sentinel event alert: health care worker fatigue and patient safety. Sentinel Event Alerts: Joint Commission. 2011;48.
16. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007 May;39(2):175-91.
17. Gray JR., Grove SK, Sutherland S. The practice of nursing research: Conduct, Critique and Utilization, Fifth Ed. St. Louis, United; 2016.
18. Åkerstedt T. Sleepiness as a consequence of shift work. Sleep. 1988 Jan 1;11(1):17-34.
19. Monk TH. A visual analogue scale technique to measure global vigor and affect. Psychiatry Research. 1989 Jan 1;27(1):89-99.
20. Uher R, Goodman R. The everyday feeling questionnaire: the structure and validation of a measure of general psychological well-being and distress. Social Psychiatry and Psychiatric Epidemiology. 2010 Mar;45:413-23.
21. Han K, Hwang H, Lim E, Jung M, Lee J, Lim E, Lee S, Kim YH, Choi-Kwon S, Baek H. Scheduled naps to improve drowsiness and quality of nursing care among 12-hour shift nurses. International Journal of Environmental Research and Public Health. 2021 Feb;18(3):891.
22. Geiger Brown J, Wieroney M, Blair L, Zhu S, Warren J, Scharf SM, Hinds PS. Measuring subjective sleepiness at work in hospital nurses: Validation of a modified delivery format of the Karolinska Sleepiness Scale. Sleep and Breathing. 2014 Dec;18:731-9.
23. Martin-Gill C, Barger LK, Moore CG, Higgins JS, Teasley EM, Weiss PM, Condle JP, Flickinger KL, Coppler PJ, Sequeira DJ, Divecha AA. Effects of napping during shift work on sleepiness and performance in emergency medical services personnel and similar shift workers: A systematic review and meta-analysis. Prehospital emergency care. 2018 Feb 15;22(sup1):47-57.
24. Dinges DF. An overview of sleepiness and accidents. Journal of Sleep Research. 1995 Dec;4:4-14.
25. Davy J, Göbel M. The effects of a self-selected nap opportunity on the psychophysiological, performance and subjective measures during a simulated industrial night shift regimen. Ergonomics. 2013 Feb 1;56(2):220-34.
26. Barthe B, Tirilly G, Gentil C, Toupin C. Job demands and resting and napping opportunities for nurses during night shifts: Impact on sleepiness and self-evaluated quality of healthcare. Industrial Health. 2016;54(2):157-62.
27. Silva-Costa A, Araú MM, Nagai R, Fischer FM. Environmental and organizational conditions for napping during night work: A qualitative study among nursing professionals. Sleep Science. 2010;3(1):11-5.
28. Hilditch CJ, Dorrian J, Centofanti SA, Van Dongen HP, Banks S. Sleep inertia associated with a 10-min nap before the commute home following a night shift: A laboratory simulation study. Accident Analysis & Prevention. 2017 Feb 1;99:411-5.
| Files | ||
| Issue | Vol 10 No 2 (2023): Spring | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v10i2.12834 | |
| Keywords | ||
| fatigue; nurses, psychological well-being; shift work; sleepiness | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Gyeltshen D, Gyaltshen K, Dorji N, Yangdon K, Wangchuk N, Drakpa L. Nurses’ napping practices and their effects on sleepiness, fatigue, well-being, and quality of nursing care. NPT. 2023;10(2):138-146.
