12-hour Shifts Research Articles

Secondary traumatic stress in working nurses studying part time in a bachelor or Master’s nursing program in Croatia: a cross-sectional study

BackgroundNurses are more likely to be exposed to human suffering than other healthcare professionals. Persons exposed to indirect trauma can experience symptoms of posttraumatic stress disorder, symptoms of avoidance, arousal and intrusion. Secondary traumatic stress (STS) occurs when a person hears about the firsthand traumatic experiences of another. This study aimed to explore the prevalence of STS among working nurses enrolled at a university nursing program.MethodsA cross-sectional study was conducted among nurses working in healthcare enrolled in university bachelor’s or Master’s nursing studies at the Catholic University of Croatia in November 2017. Data were collected using the Secondary Traumatic Stress Scale (STSS) and two items from the World Health Organization quality of life brief version (WHOQOL-BREF).ResultsThe study included 151 students; the response rate was 70%. The mean STS score was 38, indicating that the students on average suffered from moderate STS. Half of participating nurses met the criteria for STS. Working nurses enrolled in Master’s studies had lower STS scores than those enrolled into bachelor studies (t = 4.14, df = 149, p < 0.01). The level of STS had a negative correlation with participants’ quality of life assessment (r=-0.392, p < 0.01) and satisfaction with their health (r=-0.387, p < 0.01). We also found a significant positive correlation between subjective assessment of quality of life and satisfaction with personal health (r = 0.432, p < 0.01). We did not find a significant association between the level of STS and sex (r=-0.094) or years of nursing work experience (r=-0.069). Level of STS varied depending on the participants’ workplace, years of experience in that workplace and their work shifts. The highest levels of STS were seen in nurses working in the internal medicine department, those with 10–14 years of work experience in the current workplace, and those who work block shifts (12-hr shift followed by 24-hour shift).ConclusionOver half of working nurses attending university studies had at least moderate STS. Furthermore, STS was negatively associated with participants’ perception of quality of life and satisfaction with their health. Prevention and alleviation interventions could reduce the burden of STS among nurses.

The predictors of lower limbs varicose veins among healthcare providers.

Lower limb varicose veins (LLVVs) are a common problem that mostly occurs among healthcare professionals, especially nurses. While the direct cause of LLVVs is not known at present, its predictors have been identified in the literature. The objective of this study is to identify the predictors of LLVVs among nurses in Jordan. This cross-sectional descriptive study was carried out in Jordan in the period between August 2022 and December 2022. This study was carried out on 407 nurses. The participants were recruited in the study using convenience sampling. LLVVs and predictors were analyzed using binominal logistic regression. The percentage of having LLVVs was 30.7%. Results showed that having a family history of LLVVs and older age were significant predictors of developing LLVVs among both male and female nurses. For male nurses, longer shift hours were a significant independent predictor of developing LLVVs, where increased number of deliveries, less sitting time, and increased weight were significant independent predictors of developing LLVVs among female nurses. This study highlighted the predictors of LLVVs among nurses, which can be considered in improving the lifestyle and quality of life of nurses in the long term.

Compliance and Side effects of face mask use in medical team managing COVID-19: A cross-sectional survey in a tertiary care hospital

Abstract Introduction The necessity of wearing personal protective equipment specially facemasks to prevent the spread of COVID-19 to healthcare workers has been emphasized in the current COVID-19 pandemic. This survey aimed to estimate the compliance and perceived side effects causing non-adherence to their use in medical personnel. Methods This cross-sectional survey was conducted in the period from March to June 2021including healthcare workers in a tertiary care isolation hospital in contact with COVID-19 cases. A designed online questionnaire was distributed to all teams and data were obtained with response rate 97.3%. Results The study included 302 participants. Adherence was recorded in 293 (97%) during shifts for mean duration of 6.84 ± 2.9 h. Nearly 53% reported changing masks during shift due mask damage, then contamination with secretions of COVID-19 or suspected patients. The causes of non- adherence were perceived dyspnea then headache in 65.3 and 17%. The most commonly reported side effects in all participants were dyspnea (87.4%), headache (42.7%), and 62.3% of the participants reported that these side effects began within 6 h after wearing the mask and 41.1% said that these side effects disappear after less than 1 h. Conclusion Adherence to use of protective facemask between medical teams during the COVID-19 in our hospital was very satisfactory. The main side effects were perceived dyspnea and headache and recorded after prolonged use. There is a need to follow the burden of these side effects to avoid non-adherence and to take measures to reduce hours of work shifts especially during pandemics.

Labor regulation of medical professionals in the universal health care system through the lens of health economics

Current events in the healthcare sector are aimed at amending the Labour Code, specifically section 93. Employees face more difficult working conditions as a result of this issue, despite the fact that this amendment is intended to protect them. The purpose of this thesis was to determine what information exists in academic, official, governmental, and discursive environments, as well as what relevant data can be extracted from the available sources to draw constructive conclusions. The entire subject is treated as a theoretical concept that analyses the situation from the standpoint of the Austrian school of economics and health economics and provides a useful perspective on the issue of health system regulation and reform.The findings reflect an opinionated reality that elicited a media response from the general public and medical personnel. There was an interim agreement on salary increases for doctors and non-medical staff in the health sector in this case. Although the Chamber of Deputies' action appears to be relatively settled, it is still practically unresolved whether doctors will be allowed to work up to twice as many hours of overtime, and although each 12-hour shift should be followed by eight hours of uninterrupted rest, we should probably brace ourselves for further possible Labor Code circumvention. Furthermore, it was noted that this and similar topics are rarely discussed in academic and scientific settings, and that there is a lack of a systemic perspective and evidence.

Critical analysis of fire incidents and self-assessment of fire safety program in a tertiary care hospital of India: an observational study

Background: Self-assessment of fire safety provides valuable insights for framing a robust fire safety program for hospitals by identifying gaps and taking corrective measures. The study was performed to (i) critically analyse fire incidents which occurred in the hospital and (ii) assess fire safety program of the hospital. Methods: A critical analysis of 3 fire incidents which occurred in hospital was performed. Further review of records regarding all fire incident reports was performed for last 4.5 years and analysed for cause, site, timing, triggering factor and firefighting. For the second objective, fire safety mechanisms in hospital were compared with national accreditation board of hospital checklist and national building code 2016 part 4 “fire and life safety” guideline. Results: It was found that a total of 44 incidents of fire occurred over a period of four and a half years from January 2019 to July 2023, of which 42 were minor, confined fires while two were major and non confined fires. Electrical cause was found in 48.84% of fire incidents, 37% occurred in external areas, 41% in the morning shift hours and in 51.16% incidents clean agent was used for extinguishing the fire. In 93.18% incidents, trained hospital security extinguished the fire. Average reporting time was 1.23 minutes and mean time taken to act and extinguish the fire completely was 10 minutes. Conclusions: Critical analysis of fire safety using records of fire incidents and comparison with guidelines helps hospitals in self assessment of their fire safety plans and guides in filling lacunae.

DEVELOPMENT OF A LOGISTICS SCHEME FOR CROSSING THE BORDER WITH THE EU BY TRAILER TRAINS WHEN TRANSPORTING GRAIN GROUP LOADS

Purpose. One of the problems that arises when crossing the land border with the EU countries by rail or road, when transporting grain cargo, is the need for phytosanitary control. It involves taking samples of cargo and performing laboratory analyzes. Customs clearance of cargo without this procedure is impossible in Ukraine. The need for phytosanitary inspection of grain cargo after crossing the border is a requirement of EU legislation for import or transit through the territory of these countries. The organization of combined transportation of grain cargo in interstate traffic in transit through Eastern European countries towards seaports is certainly an urgent task. This is confirmed by the redistribution of grain exports with an increasing share of these cargoes moving through western crossings. The organization of combined containerized transportation is conditioned by the limited processing capacity of transshipment points and railcar change points at border stations. The purpose of this article is to build a logistics chain for crossing the border by container trains running from Khyriv station of the regional branch of Lviv Railway to Przemysl-Bakonczyce station of Polish State Railways, subject to preliminary phytosanitary control directly at Khyriv station under the control of the Polish side. The article also solves the problem of building a train schedule with the coordination of the duration and schedule of working hours of the locomotive crews of the freight locomotives of the Polish State Railways at Medyka or Przemyśl stations. Methods. Methods of production process control and methods of schedule theory were used. Findings. The sequence and duration of technological operations performed at the Khyriv station, which are 1.2 hours, provided that cars are ready for departure in an amount sufficient to fill all train platforms, have been developed. The consumption of locomotive hours for running a counter-railer train between the initial and final stations is calculated, which is 4.7 hours. It is established that during a 12-hour work shift of the locomotive crew of Polish State Railways, two trains can be serviced with a departure interval between them in the range of 5...7 hours. Practical value. The results of this work can be used in the development and construction of schedules for the movement of container trains in cross-border traffic.

Unmasking the impact: unveiling the effects of 12-hour shifts on performance among South African police officers

The South African Police Service (SAPS) has implemented a shift system in which police officers are scheduled to work for four consecutive days, resulting in a total of 48 hours per week. The implementation of the 12-hour shift pattern has been found to have an adverse effect on police officers. Consequently, this appears to have a detrimental effect on police effectiveness. Studies investigating the effects of the 12-hour shift have revealed that this work schedule significantly influences the reaction time, sleep patterns, and overall health of police officers, thereby impacting their performance. This study aims to provide a qualitative analysis of the effects of the 12-hour shift on police performance at Pretoria Central (SAPS) Police Station in Gauteng Province, South Africa. Data was collected from eight (8) individuals from the SAPS, namely at Pretoria Central Police Station, using semi-structured interviews. The participants have suggested that officials in the SAPS should evaluate the existing shift structure and increase the deployment of police officers at the police station. This would help alleviate the workload of the officers and enhance service delivery.

Nurses’ occupational physical activity and workload in a perioperative intensive care unit in Slovenia

The field of nursing includes heavy occupational physical demands, including walking and standing for longer periods of time, in addition to moving and lifting. As such, in the context of a typical work shift, many nurses generally achieve the World Health Organization's recommended 10,000 steps per day. This study aimed at estimating the daily physical activity and workload of nurses in a perioperative intensive care unit. The data sources for this study included data from the hospital information system on various procedures and interventions, and the Silva Ex3 Plus pedometers for measuring steps, kilometers, calories, and activity time across various shifts in a perioperative intensive care unit. Twenty nurses from Slovenia volunteered to participate in this observational study. Over 13 weeks, a nurse working an 8-hour shift walked an average of 5,938 steps (4.4 km). However, nurses who worked a 12-hour weekend day shift came very close to the World Health Organization’s recommendation with an average of 9,003 steps (6.5 km). A total of 227 patients were admitted and an average of 80 nursing interventions were performed per day and there was a positive relationship between physical activity, workload, and patient admissions in the perioperative intensive care unit (p = 0.001). Results of this study could help managers better understand nurses' physical activity and workload during various shifts in the perioperative intensive care unit.

Human reliability assessment in hydrogen refuelling stations: A system dynamic approach

This study develops a methodology using a system dynamics approach to analyse human error probability (HEP) within the context of hydrogen fuelling station (HFS) maintenance, mainly focusing on the dynamic nature of performance shaping factors (PSFs) over time. The developed model offers a comprehensive understanding of how diverse human factors dynamically influence task performance, yielding critical insights for safety management strategies to study 8-hour day shifts in maintenance activity. The study explores the intricate relationship between time-dependent PSFs and human error probability, highlighting that as the number of maintenance tasks rises, so does the potential for increased fatigue levels, subsequently elevating HEP. Introducing breaks during work emerges as a promising intervention to mitigate task-related fatigue, reducing HEP. Careful break implementation is necessary to prevent shifts from extending, which could inadvertently raise HEP. This research has implications extending beyond HFS, benefiting industries where operational safety and efficiency are paramount. Future studies can build upon these findings, exploring additional interventions and diverse work scenarios to advance our understanding of human performance and error prevention strategies, ultimately fostering safer and more productive work environments. The integration of system dynamics and the insights gained contribute significantly to hydrogen safety and offer a robust foundation for future investigations in this field.

Does the number of pages received per hour affect resident productivity?

Workflow interruptions are common for emergency physicians and are shown to have downstream consequences such as patient dissatisfaction, delay in clinical response, and increase in medical error. However, the impact of passive interruptions on physician productivity is unclear and has not been well studied. We sought to evaluate if the number of pages received per hour significantly affects the number of patients seen per hour. Retrospective data was collected on resident physician (RP) emergency department shifts from July 1st, 2021 to June 30th, 2022 at an academic medical center with an annual census of 55,000 patients. A total of 2865 RP shifts were collected among the 26 postgraduate year (PGY) 1 and PGY2 residents. For each RP shift, we identified the number of pages received per hour and the number of new patients seen per hour. Pages consist of any transmitted message that was sent to the RP's personal pager, which includes both automatic (eg, bed assignments, abnormal lab values) and personalized pages from other healthcare practicioners(eg, nursing, consultants). Data were analyzed using Poisson regression controlling for clustering at the physician level to determine if the number of patients seen per hour is significantly affected by the number of pages (divided into quartiles) received. We found the number of pages received per hour did not decrease the number of patients seen per hour. Contrary to our hypothesis, there was a strong positive relationship between the number of pages received per hour and the number of patients seen by RPs in that hour and subsequent hours. During the middle of a shift (hours 3, 4, and 5), RPs receiving pages in the third and fourth quartile (top 50% of pages) saw significantly more patients during that same hour and the next hour (p<0.001). The number of pages received by RPs per hour did not decrease the number of patients seen per hour. When RPs receive a higher number of pages, there is a positive association with the number of patients they see in that hour and subsequent hours. Further studies will be needed to determine whether the content of pages affects resident productivity.

Development and evaluation of the automated multipurpose molecular testing system PCRpack for high-throughput SARS-CoV-2 testing

ABSTRACT Increasing the reliable testing capacity for SARS-CoV-2 is important for the diagnosis and control of COVID-19. We developed an automated, customizable, easy-to-implement molecular testing system, named PCRpack, for the high-throughput testing of SARS-CoV-2. PCRpack includes a liquid handling instrument enclosed in a negative-pressure clean booth (Biomek i5), a laboratory information management system (SimpPCR), other equipment, and documents that are needed for testing operation. An in vitro diagnostic assay was employed to detect SARS-CoV-2. System performance was evaluated based on liquid handling accuracy and precision, analytical sensitivity, clinical diagnostic performance, and testing capacity per day. Clinical diagnostic performance was determined against the reference extraction-based reverse transcription-PCR assay using 3,965 upper respiratory samples. Analytical sensitivity analysis showed a lower limit of detection of 1,000 genome copies/mL of sample. The accuracy and precision of sample or reagent dispensing in PCRpack ranged from −2.24% to 0.73% and 0.83% to 4.52%, respectively. In the evaluation of clinical samples, PCRpack showed a positive percent agreement of 96.6% and a negative percent agreement of 100% compared with the reference assay. The average turnaround times per 94 samples and the maximum numbers of tests within an 8-hour shift of one operator were 2 hours and 28 minutes vs 2 hours and 1 minute and 564 vs 376 samples for PCRpack and the manual method, respectively. The developed PCRpack system shows high liquid handling and clinical diagnostic performance and is a promising testing system for increasing the SARS-CoV-2 testing capacity and testing future emerging pathogens. IMPORTANCE Accurate and fast molecular testing is important for the diagnosis and control of COVID-19. During patient surges in the COVID-19 pandemic, laboratories were challenged by a higher demand for molecular testing under skilled staff shortages. We developed an automated multipurpose molecular testing system, named PCRpack, for the rapid, high-throughput testing of infectious pathogens, including SARS-CoV-2. The system is provided in an all-in-one package, including a liquid handling instrument, a laboratory information management system, and other materials needed for testing operation; is highly customizable; and is easily implemented. PCRpack showed robust liquid handling performance, high clinical diagnostic performance, a shorter turn-around time with minimal hands-on time, and a high testing capacity. These features contribute to the rapid implementation of the high-performance and high-throughput molecular testing environment at any phase of the pandemic caused by SARS-CoV-2 or future emerging pathogens.

Public opinion of resident physician work hours in 2022

ObjectiveThe purpose of this study was to characterize public awareness and opinion regarding resident physician work hours in the United States. MethodsWe conducted a nationally representative cross-sectional survey among adults in the United States. Demographic quota-based sampling was conducted by Qualtrics to match 2020 United States Census estimates of age, sex, race, and ethnicity. Descriptive statistics are presented. Hypothesis testing was conducted to identify characteristics associated with agreement with current resident physician work-hour policies. Results4763 adults in the United States participated in the study. 97.1% of the public believes that resident physicians should not work 24-hour shifts and 95.6% believe the current 80 hours resident work week is too long. 66.4% of the participants reported that the maximum shift duration should be 12 consecutive hours or fewer, including 22.9% who recommended a maximum shift length of 8 hours. Similarly, 66.4% reported that maximum weekly work hours should be 59 or fewer, including 24.9% who recommended a maximum of 40 weekly work hours. ConclusionsNearly all US adults disagree with current work-hour policies for resident physicians. Public opinion supports limiting shifts to no more than 12 consecutive hours and weekly work to no more than 60 hours, which is in sharp contrast to current regulations that permit of 28 hours shifts and 80 hours of work per week.

Exploring the effects of break nurses on nursing staff burnout

Objective: Previous studies had found that rest breaks can not only prevent or improve negative reactions to stress in healthcare staff, but also reduce turnover in understaff conditions, improve work performance, and ultimately improve patient outcomes. As a result, many inpatient units had implemented a nursing position called a Break Nurse, whose sole purpose was to provide rest breaks. However, the implementation of a Break Nurse and its effectiveness was not reported in literature. Therefore, this quality improvement QI project proposed to implement Break Nurses on an acute care unit of impatient setting and investigate its effectiveness on nursing staff.Methods: The selected unit previously utilizing a Break-Buddy model for securing rest breaks was able to start a two 8-hour shift Break Nurse model. The hypothesis is that the Two-Break-Nurse model, when compared with the Break-Buddy model, will better secure rest breaks, reduce burnout symptoms experienced by nursing staff. The validated tool used to measure burnout is the Maslach Burnout Inventory. The study utilized pre- and post-implementation self-report survey statistical analysis to report outcomes.Results: In the end, 14 individuals had responded to both pre- and post implementation surveys. The results show that there was statistically significant improvement of Emotional Exhaustion. Due to the small sample size, the measurement of Depersonalization and Personal Accomplishment did not show statistically significant improvement.Conclusions: The Two-Break-Nurse model is effective at reducing emotional exhaustion for nursing staff. Further studies are needed to measure in a larger scale the effectiveness of break nurse model on other aspects of burnout and the improvement of clinical outcomes.

Evaluation of biochemical parameters in operating room staff exposed to radiation and anesthetic gases.

Exposure to ionizing radiations and other hazardous agents such as anesthetic gases pose serious risks to the health of healthcare workers. This study aimed to evaluate the changes in blood and biochemical parameters of the operating room staff exposed to ionizing radiations and remnants of anesthetic gas. This cross-sectional study was performed at (Ayatollah Taleghani Hospital). The control group was selected from different parts of the hospital that were not exposed to ionizing radiations and anesthetics, including the office, services, and treatment. The case group included all operating room personnel. Hematopoietic parameters such as complete blood count and WBC differential, and parameters of liver function such as serum activity of liver enzymes (ALT, AST, ALP, LDH) and serum bilirubin levels, fasting blood sugar, serum lipid profile, level of vitamin D and magnesium were measured for the exposed and referent subjects. Additionally, a checklist was used to gather data regarding the occupational variables and medical histories of the studied subjects. The mean values of Hb, Hct, Vitamin D, and MCHC, as well as the RBC count, were significantly lower in the exposed individuals than in the referent subjects. In contrast, the proportion of smokers was significantly higher in the exposed group than in the referent group. No significant differences were noted between exposed and unexposed groups as far as other parameters were concerned. However, no significant differences were noted between the case and control groups as far as other measured parameters were concerned. Likewise, no significant differences were noted between exposed and referent groups as far as blood types, history of underlying diseases, work history, working hours per month, number of morning and evening shift hours, type of diet, consumption of a high-fat diet a day before blood sampling, X-ray in the recent year, history of radiotherapy, and therapeutic agents use was concerned. Exposure of operating room staff to ionizing radiations and waste anesthetics gases is associated with subtle, subclinical prepathologic decreases in some hematopoietic parameters such as hemoglobin, hematocrit and MCHC levels, RBC count as well as vitamin D levels.

Ants Sleep, Plants do not: The Variation in Species’ Activity Influences the Topology of Interaction Networks

The emergence of graph theory allowed using the complex network approach to aggregate detailed information about interactions between species. Although the use of the complex network approach has improved the understanding about community structuring, few aspects such as the temporal variation in the species’ activity pattern in the networks’ topology were explored so far. The current study used the ecological network approach to investigate ants interacting in the extrafloral nectary (EFN) of plants in order to test the hypothesis that the temporal variation in the foraging behavior of these animals affects the networks’ topology. In order to assess the temporal effect on the interaction networks, 24-hour collections divided in two 12-hour shifts (day and night) were performed in 20 plots, thus totaling 288 collection hours over 6 months. The ant-plant interaction networks presented similarity among the topological metrics assessed throughout the day. Different ant species presented distinct foraging times. Thus, two modules referring to the day and night shifts emerged from the network and presented specific species at each foraging shift. On the other hand, the plants kept on providing the resource (active EFNs) throughout the day. The results found in the current study have shown that ecological networks keep their structures constant; however, the ecological processes ruling these networks can better respond to the effects caused, for example, by the temporal variation in species’ activity. Therefore, it is worth always taking into consideration the importance of ecological processes at the time to analyze interactions in the nature.

Which Criteria Should We use to Determine an Adequate Number of Linear Accelerators in Emerging Economy Countries

In the age of limited resources, knowing the number of linear accelerators (LINACS) is paramount for designing and planning comprehensive coverage for a population. As important guidelines for the actual prediction of the number of LINACS, a wide range of directions are found in the literature. These guidelines vary depending on total population size, cancer incidence, cancer types, fractions per year, and machine workload. Knowing which guidelines to use, and which one fits the population's needs, is key to the best utilization of resources. In Oman, we have a stable population with minimal rates of immigration/emigration. The current needs of LINACS are met so we have a unique opportunity to test some of these guidelines and see which one most accurately predicts the correct number needed. The results should help emerging economies use a similar approach in estimating their needs. This study was conducted to estimate the demand for radiotherapy services needed in Oman taking into consideration the most common methods and recommendations available in the literature. The calculation methods analyzed: COCIR - targets a density of 7 radiation therapy units per million; ESTRO/QUARTS - 1 LINAC per 400 patients/year or 1 LINAC per 180,000 persons; and IAEA method that uses a combination of cancer incidence, number of treatment fractions per cancer type, and machine workload. The population demographics with cancer incidence were extracted from the Oman Cancer Registry data 2019 (total number of cases and cancer types). For the density of LINAC units per million population, we used the 2019 population of 4.603 million. For the workload calculation, we used 4 fractions/hour in an 8-hour shift and 248 working days. The calculations included the total number of cancer cases, average number of fractions per year, machine workload, rate of patients receiving radiotherapy per cancer type, the optimal number of fractions per treatment course, retreatment rate, and radiotherapy utilization rate per cancer type. Based on most frequent cancer incidence (1,437 cases), the total number of fractions per year is 22,920. The workload of machines was 7,936 fractions/year. If calculations included total number of cancer types (2,039) and average number of fractions per patient based on average number of fractions per cancer site, the total number of fractions is 27,715. If the reirradiation ratio included the number of fractions per year, a total of 34,644 (25% increase). For the COCIR, ESTRO/QUARTS, and IAEA recommendations, the range is 2.8 to 32 of required LINACS for adequate coverage in Oman (respectively 32; 4 to 25; and 2.8). The analysis of recommended guidelines for calculating the required number of LINACS in Oman showed a wide range. While in practice we know currently the number of LINACS required for our population is 5, for emerging economies 1 LINAC per 400 patients/year, or the IAEA calculation methods are the closest approximation to the actual needs.

O.2.3-9 The working shifts &amp; physical literacy factors associated with physical activity level in various settings among nurses: preliminary results

Abstract Purpose This study aims to examine (I) the importance of working shifts on physical activity (PA) level and (II) the association between physical literacy (PL) and energy spent with PA in occupational, leisure-time, and sports settings among nurses who live most of their time in healthcare environments and are aware of health literacy and PA. Methods The data of this cross-sectional study were collected from 201 nurses (MAGE= 34.53±8.41; MBMI= 24.32±4.17) nurses working at hospitals in Eskisehir. Woking shifts were 08:00-16:00 (n = 53), 16:00-08:00 (n = 19), alternating between 08:00-16:00 and 16:00-08:00 (n = 47), and 24-hour shifts with a day off between shifts (n = 82). The 7-Day PA Assessment Questionnaire developed by Karaca and Turnagöl (2007) was used as a data collection tool as it enables individuals to report their various types of physical activities (occupational, leisure-time, sport) in the past seven days, and the energy spent is computed in terms of MET. Moreover, the Turkish version of the PL Questionnaire (Munusturlar and Yıldızer, 2021) was used to measure PL level in knowledge, communication, and self-awareness subdimensions. The data were analyzed with One-way ANOVA and multiple linear regression models. Results The one-way ANOVA results indicated nurses working in 24-hour shifts reported significantly higher MET values (276.05±71.07 MET/week) in occupational PA than nurses working between 08:00-16:00 (222.00±53.70 MET/week) and 16:00-08:00 (223.27±73.67 MET/week) shifts, F(3, 200)=8.539, p &amp;lt; 0.001. Regression models indicated that PL was only associated with spent energy in sports activities [F(4,200)=9.21, p &amp;lt; 0.001], but not with occupational and leisure-time PA. Lastly, knowledge was the only PL factor associated with energy spent on sports activities (ß=1.35, OR:0.77-1.93). Conclusions 24-hour working shifts with day-offs increase energy expenditure with occupational physical activity, however, there was no significant differences were found in energy expenditure with leisure time or sports activities in favor of those who work in these shifts. Moreover, increased physical literacy knowledge is the only factor for increasing physical activity participation through sports activities. Hence, policies, PA prescriptions, and interventions should focus on PL knowledge and understanding. Support/Funding Source This study was supported by Eskişehir Technical University Scientific Research Projects Commission under grant no: 23LÖT069.

Nursing 12-Hour Shifts and Patient Incidents in Mental Health and Community Hospitals: A Longitudinal Study Using Routinely Collected Data

Shifts of 12 hours or longer are common in nursing services within general hospital wards. Concerns have been raised about their safety, but previous research has mostly used staff-reported measures of quality and safety and has occurred in general hospital settings only. This study aims to measure the association between the use of 12+ hour shifts in nursing staff (including registered nurses, healthcare support workers or nursing assistants, and nursing associates) and the rate of patient incidents in mental health and community hospitals. This is a longitudinal study using routinely collected data from two mental health and community NHS trusts in the South of England. We accessed rosters of nursing staff and patient incident data from April 2018 to March 2021. We extracted 1,018,971 shifts and excluded those not worked by nursing staff, with a final sample of 898,143 shifts. We extracted 53,078 incidents. We only included incidents that involved patients and that occurred in wards. Our final sample consisted of 38,373 patient incidents. We linked all patient incidents and nurses’ worked shifts at the ward-day level. Depending on the distribution of incident rates, we used either negative binomial mixed-effects models or Poisson mixed-effect models to investigate the association between the proportion of 12+ hour shifts and all patient incidents, violence against staff, falls, self-injury, disruptive behaviour, and medication management incidents at the ward-day level. We found a relationship between 12+ hour shifts and the incident rate. Compared to days in wards with no long shifts, increasing the proportion of long shifts was initially associated with a small increase in the overall rate of incidents, but the rate increased sharply as the proportion of long shifts was above 70%. Rates of self-injury increased more steadily as the proportion of long shifts increased. The mandatory implementation of long shifts should be discouraged.

Hospitalization for acute heart failure during non-working hours impacts on long-term mortality: the REPORT-HF registry.

Hospital admission during nighttime and off hours may affect the outcome of patients with various cardiovascular conditions due to suboptimal resources and personnel availability, but data for acute heart failure remain controversial. Therefore, we studied outcomes of acute heart failure patients according to their time of admission from the global International Registry to assess medical practice with lOngitudinal obseRvation for Treatment of Heart Failure. Overall, 18553 acute heart failure patients were divided according to time of admission into 'morning' (7:00-14:59), 'evening' (15:00-22:59), and 'night' (23:00-06:59) shift groups. Patients were also dichotomized to admission during 'working hours' (9:00-16:59 during standard working days) and 'non-working hours' (any other time). Clinical characteristics, treatments, and outcomes were compared across groups. The hospital length of stay was longer for morning (odds ratio: 1.08; 95% confidence interval: 1.06-1.10, P<0.001) and evening shift (odds ratio: 1.10; 95% confidence interval: 1.07-1.12, P<0.001) as compared with night shift. The length of stay was also longer for working vs. non-working hours (odds ratio: 1.03; 95% confidence interval: 1.02-1.05, P<0.001). There were no significant differences in in-hospital mortality among the groups. Admission during working hours, compared with non-working hours, was associated with significantly lower mortality at 1year (hazard ratio: 0.88; 95% confidence interval: 0.80-0.96, P=0.003). Acute heart failure patients admitted during the night shift and non-working hours had shorter length of stay but similar in-hospital mortality. However, patients admitted during non-working hours were at a higher risk for 1year mortality. These findings may have implications for the health policies and heart failure trials.

Nurses' Rest Breaks and Fatigue: The Roles of Psychological Detachment and Workload.

Rest breaks have been shown to reduce acute fatigue, yet not all nurses who take rest breaks report lower fatigue. Psychological detachment-letting go of work-related thoughts-during rest breaks and workload may be key factors in explaining this phenomenon. To examine the mediating role of psychological detachment during rest breaks and determine how workload moderated that pathway to lower acute fatigue among hospital nurses. In this cross-sectional study, data were collected from 1861 12-hour shift nurses who answered an online survey between July and September 2021. The survey included measures of occupational fatigue, psychological detachment from work, workload, and questions on breaks, work, health, and demographics. Structural equation modeling was used in Mplus 8.9 software to estimate the direct and indirect effects of rest breaks on acute fatigue at 3 levels of workload. Nurses, on average, reported high acute fatigue, rarely experienced psychological detachment during rest breaks, and reported heavy workloads. Around 60% were able to sit down for a break on their last shift but with patient-care responsibilities. The relationship between taking a rest break and acute fatigue was fully mediated by psychological detachment from work. However, this relationship only held in the context of manageable workloads. Our findings showed that within-shift recovery is possible when nurses can psychologically detach from work during rest breaks. However, this within-shift recovery mechanism was disrupted for nurses with heavy workloads.