Project Details
The discussion aims to close check on the main integrative review upon which the understanding of the long term implications can be solved. This entails the long night working hours which in reality affects the nursing schedule. Moreover, the nursing under this category works even during the night hours to check the health progress of their victims, patients in this case. Night shift is as well accompanied by both the negative as well as positive impacts. In consideration, the study seeks to check on the two principal objectives which include the general effects of sleep and that of fatigue which is brought about by long working hours mostly at night. Lack of sleep, in reality, alters the manner through the nurses are working towards their patients. The health of the nurses is altered which indicates there is no proper coordination and workability of the nurses Kritsonis, (2005). Therefore, it’s quite relevant to recognize the evidence-based practices which can aid to overcome the problems which are experienced as a result of consecutive long nightshift working hours.
Description of the Conclusion
Patient-centered care is always affected in many ways in the organizational setup. Some of the factors which affect its general conduct include regulatory requirements, hospital practices, and reimbursement. Thus, each organization has to strive to make great efforts to seek ways and means in which they can care about the welfare of the nurses as required by the nursing code of ethics. Therefore, the involved stakeholders must come up with strategies which in general shall incorporate both the patient and their family welfare including the working hours of the nurses Roussel,(2013). The action shall be indicated that the art of caring is more considerate since it also indicated on the nursing code of conduct.
Moreover, as the main principle in the practice of nursing, similar to other professionals, the affective cognition is the fundamental task. Therefore, the provision of better health services should rhyme with the manner through which the nurse’s welfare is counter checked. With all these factors in consideration, there shall be a high level of patient-centered care as well as an increment on the satisfaction of the service upon the patients.
Furthermore, from the studies conducted, the night shift may alter the manner through which the nurses are delivering their services. Nonetheless, the nightshift is believed to be the root and the foundation of filthy services given to the patients. This is accompanied by the fact that the night shift nurses are affected by the circadian rhythm. This rhythm affects human beings in a number of ways. Some of them include regulation of the cognitive functioning, alertness, quality of sleep, hormone secretion as well as the core body temperature Roussel, (2013). Moreover, sleep disruption alters cardiovascular disease mainly because there is a change in hormone and also the Chronic fatigue syndrome. Nonetheless, there are other chronic problems associated with the circadian rhythm. These include the increment of the risk associated with the development of diabetes mellitus. This is brought about by the issue of the digestive system, where there is increment on the carcinogenic potency Roussel, (2013). Thus, it’s relevant for the nurses as well as the involved health care providers to employ the required strategies to mitigate this disruption of the circadian rhythm with dire need of protecting the patients from the harm of the nurses who have the stress of the prolonged lack of sleep.
Summary of the Results
From the nursing perspective, the nurses are required to go through a planned schedule over a fortnight duty roster. This will require the nurses to have a prior rest to prevent them from stress, exhaustion, fatigue as well as increased indices on physiological. This can also be compared to the nurses who work during daytime which entails the morning or the afternoon shifts. Moreover, from the study, it’s clear that the nurses who lack adequate sleeping fail to deliver quality services unto their respective patients Sullivan, (2012). Thus, they fail to achieve the Australian Board of Nursing and Midwifery. This from the cross-sectional study which indicated that only a smaller amount of nurses received the required amount of sleep.
Moreover, from the medication point of view, medication is one of the main activity, upon which the health of a patient is dictated, and the plan set appropriately and prescription of the health improvement outcome. Hence, medication administrations, as well as improvement on the preparation, are considered as the most fundamental activities Sullivan, (2012). This is to prevent any type of error which might be experienced due to an error prior to prolonged long working hours.
Additionally, lack of adequate sleep marks the commencement of body fatigue. Fatigue is one of the major cause of an error which might occur all along with the conduct of nurses. This issue has been noted in a good number of nurses who work on the nightshift, simply due to the disruption of the circadian rhythm. Moreover, it’s quite tough for nurses who work on the night shifts to upgrade their educational development. This is because they fail to get time to attend the educational forums and workshops Sullivan, (2012). Thus, they remain at their respective position for a couple of years since they cannot be promoted to another higher nursing grade. Thus, it’s so traumatizing to see other nurses attaining higher levels from their education experiences whistle one is just stagnant at one particular position. Hence, there is a disadvantage of achieving the dictated NMBA3.3 standard.
Purpose of the Topic: Relevance of the Results
Through this review, the main task is to offer a quite clear understanding of the overall effects of the long-term night shifts, more so in the field of nursing. This shows that the evidence-practices shall be offered in line with the specific purpose of offering a solution. The solution shall be set to offer the reduction of the confirmed complications experienced by the consecutive night shift workers in the field of nursing Kritsonis, (2005). Also, this is done to ensure that the quality of the patients’ care, particularly during the night hours should be equal to those working during the day. This includes the activities being undertaken during the day such as educational workshops as well as the supportive educational forums.
Research Question and Future Directions
From the nursing perspective, the review seeks to give solution to the following query, “what are the overall impacts on the long-term night shift on the nursing field and the ability to provide quality care to the patients?”
Design/Framework and the Impact of the Study
From the integrative review, it’s quite clear that this is based upon the framework unto which the description of offers Jones, & Gates, (2007). This is a broader perspective and review upon the presented literature. The involved literature thus shall not entail any kind of statistical analysis. Nonetheless, the study shall present and drew its conclusion from the different areas of research work and methods such as the mixed, qualitative, systematic as well as quantitative methods.
The expected data shall be retrieved from the comprehensive database search unto which the Cumulative Index upon Nursing and Allied Health Literature (CINAHL), PlosOne, EBSCO host and the Science Direst. This database is believed to been retrenched and conducted in the period running from 2000 to 2019. Being limited to the peer-reviewed journals; the studies are believed to have been conducted to humans and presented in the English language as well as being availed in the full text. Moreover, the research was conducted on the permanently night nurses, since they were the only person with the prerequisite knowledge required. Additionally, only those who are registered are the specific nurses who should answer the queries. Simply because of their higher experience in the field of nursing, more so working on the night shifts. Nonetheless, any article or the journal which entails information which is contrary to the nightshift perspectives Sullivan, (2012). Thus, each article must entail information on nursing, particularly the night hours. Thus, to get much information, there was dire need of selecting the keywords or the abbreviations which can be applied to search for long term usage. Thus, the following are the specific terms which can be applied. This include: “long term”, “fatigue”, outcome of patients”, “patient care”, “errors” as well as “nurs”. With the application of the Boolean operational categories, as well as the application of the MeSH as the key subject, the result is thus expected from various and across the database. Afterward, the search process shall display table.
Quality Appraisal to Spear Go Ahead
Furthermore, the review is also set to apply the AMSTAR 2 as the quality appraisal type of review for assessing the evidence which shall be recorded as well as underpinning the research which is proposed. AMSTAR 2 can define as the tool which is recognized as the most applicable tool for the critical analysis and the evaluation of the health care interventions Jones, & Gates, (2007). Afterward, the results shall be displayed on a table of documentation.
The Potential Significance unto forwarding Movement
As per the earlier argument on this particular discussion, disruption of the circadian rhythm as well as other health problems, which are caused by the permanent working on the night hours, that is the night shifts, the outcome might compromise the safety of the patient in consideration of the quality health care services. Therefore, the nurses are expected to suffer from Chronic Fatigue Syndrome, which is often precipitated by the burnout as well as the absenteeism Jones, & Gates, (2007). The two might increase due to the cost of care delivery as well as the disruption of the working environment and the staff increment.
Furthermore, deprivation of sleeping is also set to increase medication errors and risk increment, which might result in the patients’ diverse outcome as well as the long duration of being hospitalized. In consideration of the long hospital stay, the patient might incur a high level of medical bills leading to a burden unto the family and the relatives. Through all this repercussion, there is dire need of a guided policy which in reality should dictate the guidelines and the health policies which should relieve of the burden of prolonged nightshifts. Thus, the nurses must be given priorities similar to the day time nurses.
Selection criteria and Search Results Summary
From the literature researched, there is evidence that abundance of this literature is focused upon the long-term effects of the work which is related to fatigue. Fatigue shall hinder the efficiency of the nurse to carry out his daily activities. Thus, the high number of the retrieved articles is talking about the disruption of the circadian rhythm on matters related to productivity and health. Nonetheless, high numbers of studies have indicated the consequences of deprivation from sleep repercussion such as the medical and treatment errors Jones, & Gates, (2007). All these articles have indicated the negative effects towards both parties, nurses and their patients. Moreover, their consequences have also been dictated.
Future directions
From the historical perspective, it’s quite clear that the study has concentrated on the interventions which can be applied to reduce the high level of fatigue in nursing and their care provision tasks. High number of the authors thus dictate that there is dire need of coming up with ways and means of close checking these problems. To come up with the future directions of the study, it’s quite relevant to come up with questions which shall aid upon achieving the future directions. They include;
How should the nurses be treated on their respective duties?
Does the nurse union operate in the recent future?
Should every nurse be registered with the nursing council?
Does the number of nurses’ matter in a health care set up?
Therefore, the solution to these queries paves the way for future directions in nursing. Also, the reason behind the prolonged nightshift is due to some cases which include lack of enough members of staff. Moreover, the respective hospital directors and managers should also work jointly to reduce and solve this menace. This can be solved by employing a high number of nurses who can work on a rotational basis. Additionally, the nurses should also report their working conditions to the respective unions, since all the nurses must be registered with the nursing unit to ensure they are safeguarded during their daily activities Kritsonis, (2005). Similarly, nurses should seek for higher remuneration and overtime dues in case they work on prolonged hours.
Conclusion
From the integrative perspective, the discussion has undergone through the required ethics processes, thus there is no hindrance on undertaking any kind of research work in this field. This means that there is no dire need of seeking relevancy from various jurisdiction stakeholders such as the Human Research Ethics Committee approval unto this review.
References
Jones, C. B., & Gates, M. (2007, September). The costs and benefits of nurse turnover: A
business case for nurse retention. Online Journal of Issues in Nursing
12 (3). Retrieved from
http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/
OJIN/TableofContents/Volume122007/No3Sept07/NurseRetention.aspx
Kritsonis, A. (2005). Comparison of change theories.International Journal of Scholarly
Academic Intellectual Diversity. Retrieved from
http://transformationalchange.pbworks.com/f/Comparison+of+Change+Theories.pdf
Roussel, L. A. (2013). Management and Leadership for Nurse Administrators, 6th Edition.
Retrieved fromhttps://wgu.vitalsource.com/#/books/9781449684440/
Sullivan, E. J. (2012). Effective Leadership and Management in Nursing, 8th Edition.
Retrieved fromhttps://wgu.vitalsource.com/#/books/9781269402170/
Appendix 1
PICO table
Appendix 2
Medline
Appendix 3
Cinahl For Night Shift Depression in Nursing
Appendix 4
Prisma 2009 Flow Diagram