Final Nap Presentation

7/31/2019 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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Documents

Final Nap Presentation