Weaver Amy L, Stutzman Sonja E, Supnet Charlene, Olson DaiWai M
The University of Texas Southwestern Medical Center, 6201 Harry Hines Boulevard, Dallas, TX 75390, United States.
The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States.
Int Emerg Nurs. 2016 Mar;25:48-52. doi: 10.1016/j.ienj.2015.08.003. Epub 2015 Sep 8.
The emergency department (ED) is demanding and high risk. The impact of sleep quantity has been hypothesized to impact patient care. This study investigated the hypothesis that fatigue and impaired mentation, due to sleep disturbance and shortened overall sleeping hours, would lead to increased nursing errors.
This is a prospective observational study of 30 ED nurses using self-administered survey and sleep architecture measured by wrist actigraphy as predictors of self-reported error rates. An actigraphy device was worn prior to working a 12-hour shift and nurses completed the Pittsburgh Sleep Quality Index (PSQI). Error rates were reported on a visual analog scale at the end of a 12-hour shift.
The PSQI responses indicated that 73.3% of subjects had poor sleep quality. Lower sleep quality measured by actigraphy (hours asleep/hours in bed) was associated with higher self-perceived minor errors. Sleep quantity (total hours slept) was not associated with minor, moderate, nor severe errors.
Our study found that ED nurses' sleep quality, immediately prior to a working 12-hour shift, is more predictive of error than sleep quantity. These results present evidence that a "good night's sleep" prior to working a nursing shift in the ED is beneficial for reducing minor errors.
急诊科要求高且风险大。据推测，睡眠量的影响会对患者护理产生作用。本研究调查了以下假设：因睡眠障碍和总体睡眠时间缩短导致的疲劳和精神状态受损会导致护理差错增加。
这是一项对30名急诊科护士进行的前瞻性观察性研究，使用自我管理调查问卷以及通过手腕活动记录仪测量的睡眠结构作为自我报告差错率的预测指标。在进行12小时轮班工作前佩戴活动记录仪设备，护士们完成匹兹堡睡眠质量指数（PSQI）。在12小时轮班结束时，通过视觉模拟量表报告差错率。
PSQI的回答表明，73.3%的受试者睡眠质量较差。通过活动记录仪测量的较低睡眠质量（睡眠时间/卧床时间）与较高的自我感知小差错相关。睡眠量（总睡眠时间）与小差错、中度差错或严重差错均无关联。
我们的研究发现，急诊科护士在进行12小时轮班工作前的睡眠质量比睡眠量更能预测差错。这些结果表明，在急诊科进行护理轮班工作前“睡个好觉”有利于减少小差错。
