Morning Shift Research Articles

Awareness of Pediatric Nurses Regarding Drug Preparation and Administration in Gaafer bin auf Children Hospital, Sudan

Background: This study aimed to assess the awareness of nurses who care for pediatric patients related with drug preparation and administration conducted in Gaffer Bin Auf children hospital. Methods: A cross-sectional study was conducted from November to December 2015, in Gaffer Bin Auf children hospital, largest pediatric hospital in Khartoum state. The total sample size was 92 participants. The self-administered questionnaire was constructed with a total of 26 questions. For data analysis, we performed nonprobability descriptive study design. Results: The results imply that Majority of respondents aged between 20-30 years (56.5%). Approximately half of the nurses held a bachelor’s degree (52.2%), while the remainder held a diploma (47.8%). A significant proportion of nurses (83.7%) reported no prior training in drug preparation and administration. Most nurses (46.7%) had 2-5 years of clinical experience, and 69.6% worked afternoon and night shifts. Regarding drug preparation and administration, varying levels of knowledge were observed among nurses. Notable percentages of nurses demonstrated awareness in areas such as double-checking during preparation (56.5%) and using distilled water or normal saline for non-contraindicated suspension drugs (56.5%), nurse answered can avoid a mistake during Preparation by prepare medication for one individual at a time with (90.2%), most of nurses have good level of knowledge regarding to drug preparation & administration practice with (65.6%). bachelor's degrees are more likely to demonstrate proficient drug preparation and administration practices compared to those with diplomas, with a significant difference of 94% (p=0.047, AOR: 0.6, 95% CI: 0.03, 1.1). This research indicating that bachelor's degree nurse graduates generally exhibit better educational preparedness for quality and safety. Additionally, participants working morning shifts are 3.4 times more likely to exhibit good drug preparation and administration practices compared to those on night shifts (p=0.011, AOR: 3.4, 95% CI: 1.3, 8.1), and 4.6 times more likely compared to those on afternoon shifts (p=0.015, AOR: 4.6, 95% CI: 1.8, 9.2). Participants with good knowledge of drug preparation and administration practices are 2.614 times more likely to exhibit proficiency compared to those with poor knowledge (p<0.001, AOR: 2.614, 95% CI: 1.78, 3.90). Conclusion: The study revealed significant insights into the demographic characteristics, educational backgrounds, and practices related to drug preparation and administration among nurses. Despite a substantial portion reporting no prior training, varying levels of knowledge were evident, with most nurses demonstrating awareness in key areas such as double-checking during preparation and using appropriate solutions for suspension drugs. While there are areas for improvement, the findings suggest a solid foundation of knowledge among nurses regarding medication safety, highlighting the importance of ongoing education and fostering a culture of continuous learning within healthcare ..............

Communication Self-Efficacy and Job Satisfaction among Nurses during the COVID-19 Pandemic

Introduction. The outbreak of COVID-19 has led to various challenges for healthcare workers, including nurses. Nurses play a critical role in the fight against this disease, and their communication of self-efficacy and job satisfaction has garnered significant attention. This study aimed to investigate the relationship between communication self-efficacy and job satisfaction of Iranian nurses during the COVID-19 pandemic. Methods. This study was conducted using a cross-sectional design. A total of 500 nurses working in hospitals in Iran were selected using a convenience sampling method. The communication self-efficacy scale and the job satisfaction scale were used to collect data. Results. The study found that nurses with higher communication self-efficacy exhibited better performance and job satisfaction in various work challenges (r = 0.56, p<0.001). However, nurses holding a master’s degree or higher reported the lowest average communication self-efficacy and job satisfaction scores during the COVID-19 epidemic. The study also explored the impact of shift work on job satisfaction among nurses and found that nurses working exclusively on the morning shift reported the highest average job satisfaction score. Conclusion. The findings of this study suggest that communication self-efficacy is an important factor in predicting job satisfaction among Iranian nurses during the COVID-19 pandemic. Therefore, it is recommended that healthcare organizations provide effective communication training sessions and mental health interventions to enhance nurses’ communication self-efficacy and job satisfaction. This can ultimately lead to improved performance and better patient outcomes.

Optimizing Work Efficiency by Addressing Operator Fatigue Concerns

The study conducted at PT. Tjiwi Kimia aimed to assess the fatigue criteria and mental load experienced by production operators of cartoon box in the context of the company's 3-shift operation. Using the Bourdon Wiersma method for fatigue evaluation and the NASA TLX method for mental load analysis, findings revealed varying levels of fatigue and mental burden across different shifts. Notably, the morning shift exhibited "Good enough" speed fatigue but "Doubtful" accuracy fatigue, while the night shift showed "Enough" consistency fatigue. Furthermore, the mental burden was highest during the night shift, categorized as "High." These findings underscore the importance of addressing shift-related fatigue and mental load in industrial settings. Recommendations for implementing 3-shift rotations with weekends off and providing short breaks reflect potential strategies to mitigate worker fatigue and improve overall well-being. Future research could explore additional factors influencing worker fatigue and mental load, such as ergonomic interventions or technological advancements in production processes. Highlight: Shift Work Effects: Assessing fatigue and mental load in industrial settings. Evaluation Methods: Bourdon Wiersma and NASA TLX for worker analysis. Improvement Suggestions: Implementing 3-shift rotations and providing breaks. Keywoard: Fatigue, Mental Load, Production Operators, Shift Work, Industrial Setting

Occupational Stress Related to Workplace Violence among Emergency Medical Workers Working in Emergency Medical Centers in Alborz Province

Background and Objectives Health system workers, especially those like emergency medical personnel who are in direct contact with patients, are highly susceptible to workplace violence. A significant consequence of such violence is occupational stress. This study aims to explore the prevalence of workplace violence and its association with occupational stress among emergency medical workers in Alborz province in the year 2022. Subjects and Methods This descriptive correlational study was conducted with 124 emergency medical workers at road and urban bases in Alborz province. The research tools included a Persian-adapted standard workplace violence questionnaire and the occupational stress questionnaire from the Health and Safety Institute of England. Data were analyzed using descriptive and inferential statistics via SPSS software, version 26. Results The findings revealed that 62.1% of participants experienced physical violence, and 90% faced psychological violence. The highest incidence of physical (47.4%) and psychological (41.4%) violence occurred during the evening shift, while the morning shift saw the lowest rates. The average occupational stress levels for workers at road and urban bases were significantly high, measured at 120.5 ± 11.49 and 110.8 ± 16.76, respectively. Occupational stress was found to correlate negatively with the age and work experience of the employees, indicating lower stress levels with increasing age and experience. Conclusion Emergency medical workers often face highly stressful and anxious situations involving patients and their families. The nature of their work frequently exposes them to violence from patients or their companions, leading to heightened occupational stress.

Assessment of the impact of the implemented learning spaces on science achievement: Building Resilience at General Tomas Mascardo National High School

General Tomas Mascardo National High School is currently facing a significant challenge of classroom shortages, posing a threat to the fundamental principle of "education for all." This study aims to evaluate the impact of makeshift classrooms on the academic performance of science subject to students during the school year 2023–2024, adopting a mixed-methods approach. The analysis reveals variations in mean percentage scores across sections and shifts, emphasizing the need to investigate specific factors influencing performance outcomes. Despite small attendance fluctuations, the overall trend suggests a high level of students’ presence, indicating a generally conducive learning environment. However, the study identifies significant disparities in academic performance, particularly in the Quarterly Assessment (Q.A) variable among makeshift classes. The negative impact on academic performance is evident, highlighted by a statistically significant deviation in Q.A scores, emphasizing a specific area of concern. Irregular attendance patterns during September and October further contribute to the negative effect on academic performance, emphasizing the need for targeted interventions to address attendance issues systematically. Themes emerging from student responses encompass environmental factors, comfort, focus, motivation, adaptation, preference for regular classrooms, teacher impact, external factors, and physical environment. Morning shift students highlight noise and discomfort as significant barriers, while afternoon shift students express mixed feelings, acknowledging spaciousness but preferring regular classrooms for comfort. Both shifts discuss motivation, with morning shift students suggesting adaptive measures and crediting supportive teachers. In contrast, afternoon shift students express various emotions, including decreased motivation due to negative thoughts and noise pollution affecting focus. External factors, distractions, and concerns related to the physical environment are prevalent in both shifts, underlining the complexity of challenges students face in makeshift classrooms. Recommendations include a comprehensive investigation into academic disparities, addressing the quality of answers, targeted interventions for attendance improvement, and a holistic approach to creating a conducive learning environment.

The effect of mask usage of the health personnel on blood gas analysis and cognitive strengthening during COVID-19 pandemic.

To investigate the effect of lengthy mask use on blood gas values and cognitive functions. The cross-sectional study was conducted in February and March 2022 at Mersin City Training and Research Hospital, Mersin, Turkey, and comprised healthcare professionals of either gender aged 20-60 years working in the 3rd level intensive care unit. Each volunteer was subjected to venous blood gas analysis at the beginning and end of the 8-hour morning shift. Coronavirus disease-2019 status was noted, and further data related to cognitive functions was collected using a 7-item questionnaire. Data was analysed using SPSS 20. Of the 63 subjects, 43(68.3%) were women and 20(31.7%) were men. The overall mean age was 33.53±6.76 years. There were 42(66.7%) subjects using N95 mask; 27(64.3%) women and 15(35.7%) men with mean age 32.38±6.54 years. There were 21(33.3%) subjects wearing surgical masks; 16(76.2%) women and 5(23.8%) men with mean age 35.95±0.76 years. Intergroup comparisons were non-significant for all the markers (p>0.05). Within the N95 mask group, potential of hydrogen and lactate values were significantly different (p<0.05), while in the surgical mask group, potential of hydrogen and partial pressure of oxygen were significantly different (p<0.05). There were 28(66.7%) subjects in the N95 group who had been affected by coronavirus disease-2019 compared to 16(76.2%) in the surgical mask group (p>0.05). Subjects in the N95 mask group had significant impaired cognitive functions compared to the surgical mask group (p<0.05). Impairment in cognitive functions in intensive care unit workers using masks could be explained by the development of intermittent long-term moderate hypoxia.

Lifestyle Profiles of Italian Oncology Nurses according to Sex, Work Experience and Shift: An Exploratory Study.

(1) Background: Several researchers have highlighted a higher incidence of overweight and obesity among nurses, and others have analyzed the quality of nurses' eating habits and their related physical activity levels. The present study assessed the differences in personal habits among Italian oncology nurses according to sex, work experience and shift. (2) Methods: A cross-sectional study was performed during September-October 2023. A Google Moduli questionnaire was created and divulgated through Facebook and Instagram "Nurseallface" social pages. (3) Results: A total of 306 Italian oncology nurses agreed to participate in this study. Significant differences were reported between sex and the nutrition dimension (p = 0.018); male nurses reported higher levels in this dimension (2.69 ± 0.43) than females (2.56 ± 0.49). By considering the role of work experience in the health-promoting lifestyle profile, significant differences were recorded in the physical activity sub-dimension (p < 0.001), especially among nurses employed for more than 30 years who reported higher levels of physical activity (5.25 ± 0.23) than the other groups. By considering the shift role in the health-promoting lifestyle profile, significant differences were recorded with a health-promoting lifestyle general score (p = 0.046), especially among nurses employed only during the morning shift who recorded higher levels in health-promoting lifestyle than the others (one shift: 2.49 ± 0.29 vs. two shifts: 2.47 ± 0.24 vs. three shifts: 2.41 ± 0.25). Additionally, significant differences were reported in the physical activity dimension (p = 0.017), since nurses employed only during the morning shift recorded higher levels of physical activity than the others (one shift: 2.96 ± 1.28 vs. two shifts: 2.55 ± 0.94 vs. three shifts: 2.48 ± 1.20). Finally, a significant difference was recorded in the nutrition dimension (p = 0.017), since nurses employed during the morning and the afternoon shifts recorded higher levels of nutrition than the others (two shifts: 2.73 ± 0.39 vs. one shift: 2.63 ± 0.43 vs. three shifts: 2.56 ± 0.51). (4) Conclusions: Nurses represent the motive of healthcare organizations. Promoting healthy lifestyles among nurses would help healthcare organizations to have a healthy workforce, and nurses themselves can be advocates for policies to improve patient lifestyles and improve chronic disease prevention.

Influence of demographic factors on prolonged length of stay in an emergency department.

A prolonged length of stay in an emergency department is related to lower quality of care and adverse outcomes, which are often linked with overcrowding. Examine the influence of demographic factors on prolonged length of stay in the emergency department. This study used a cross-sectional design. It used secondary data for all patients admitted during the specific duration at the emergency department of a governmental hospital in Saudi Arabia. The independent variables were gender, age, disposition status, shift time, and clinical acuity (CTAS) level while the dependent variable was prolonged length of stay. The study shows that 30% of patients stay at the emergency department for four hours or more. The results also show a significant association between demographic factors which are age, gender, disposition status, shift time, clinical acuity (CTAS) level and prolonged length of stay in an emergency department. Based on the results males are more likely to stay in the emergency department than females (OR = 1.20; 95% CI = 1.04 to 1.38). Patients aged 60 and older are less likely to stay in the emergency department than patients aged 29 or smaller (OR = 0.58; 95% CI = 0.39 to 0.84). According to disposition status discharged patients after examination stays in the emergency department more than admitted patients after the examination (OR = 2.78; 95% CI = 1.67 to 4.99). Patients who come to the night shift are less likely to stay in the emergency department than patients who come in the morning shift (OR = 0.67; 95% CI = 0.56 to 0.81). Patients who are classified in level three of CTAS are less likely to stay in the emergency department than patients who are classified in level one (OR = 0.28; 95% CI = 0.88 to 0.023). Demographic factors such as age, gender, shift time, disposition status and clinical acuity (CTAS) were important factors that needed to be considered to reduce the length of stay of patients in the emergency department. it is possible to formulate a machine learning model to predict the anticipated length of stay in the hospital for each patient. This prediction with an accepted margin of uncertainty will help the clinicians to communicate the evidence-based anticipated length of stay with the patient's caregivers. In addition, hospital managers need to provide the emergency department with enough staff and materials to reduce the length of stay of patients.

The Impact of the Double School Shift System on Lifestyle Behaviors Among Mexican Adolescents

PurposeEarly school start times could adversely impact adolescent sleep duration. They could also impact other behaviors like diet and physical activity, either directly or indirectly through effects on sleep. We examined whether the double school shift system was associated with sleep, diet, and physical activity behaviors among Mexican adolescents. MethodsThe analytic sample included 305 Mexican adolescents from a cohort study (on average 14.53 ± 1.75 years old and 51% male). Sleep and physical activity were measured with wrist actigraphy, while diet and other lifestyle behaviors were assessed with questionnaires. Regression analyses were conducted to compare lifestyle behaviors between the morning and afternoon school shifts, adjusting for potential confounders. ResultsAdolescents attending the morning school shift (44%) had pronounced differences in sleep compared to those attending afternoon shift, including a 1.77-hour shorter sleep duration on weekdays (95% CI -1.55, −2.00), a 0.40-hour longer sleep duration on weekends (95% CI 0.10, 0.70), higher social jetlag (1.07 hours with a 95% CI of 0.87, 1.27), and an earlier chronotype. Morning shift students also had 0.85 hours longer sedentary time (95% CI 0.61, 1.10) and higher consumption of a meat and starchy food dietary pattern. Among boys only, morning shift was associated with a lower likelihood of smoking and higher consumption of a breakfast pattern. DiscussionOverall, attending a morning school shift was associated with shorter sleep, more social jetlag, greater sedentary time, and higher consumption of a meat and starchy diet. However, among boys, a few healthier behaviors were observed for the morning versus afternoon shift.

The Effect of the Time of In-hospital Cardiopulmonary Resuscitation on the Immediate Outcome in Pediatric Patients

Background: We aimed to identify the factors affecting the in-hospital Cardiopulmonary Resuscitation (CPR) to investigate the effect of the time of in-hospital CPR on its immediate outcome in pediatric patients. Methods: This retrospective study investigated CPR events performed at a teaching hospital in Tehran, Iran, from March 2018 to March 2019. After obtaining the necessary academic and ethical approvals, the pertinent data were transcribed from patient records and analyzed. No identifying data about patients or their families were extracted. Results: Chi-square test showed a significant difference in the occurrence of CPR on two-hour time blocks (p=0.041), with dips at 0-2 a.m. and 12-2 p.m. and heights at 2-4 p.m. and 6-8 p.m. (representing 5, 6, 17 and 17 CPR events, respectively). The occurrence of CPR during the night shift was significantly less than in the morning and evening shifts (p=0.000 and 0.005 respectively). Of 161 subjects with a known immediate outcome of CPR, 86 (53.4%) survived, and 75 (46.6%) died. The outcome was significantly less favorable in the evening shift compared to the morning shift (p=0.028), but no significant differences in the outcome were found between morning and night shifts (p=0.163), evening and night shifts (p=0.256), day and night (p=0.637) or workdays and weekends (p=0.925). Conclusion: We found a significantly higher occurrence of CPR at 2-4 p.m. and 6-8 p.m., at the beginning and end of the evening shift and a higher rate of post-CPR death in this shift.

Violence against physicians working in public tertiary care hospital of Bangladesh: a facility-based cross-sectional study

BackgroundViolence against physicians in the workplace is a prevalent global issue, and Bangladesh is no exception. Such violence significantly disrupts healthcare delivery and the attainment of universal health coverage. This...

Predictive Factors for Physiotherapy Session Length at an Adult Intensive Care Unit: A Longitudinal Panel Study

ObjectiveTo identify predictive factors for the length of physiotherapy sessions for adult intensive care unit (ICU) patients. DesignLongitudinal panel study. SettingICU of a secondary-care public teaching hospital, the University Hospital at the University of Sao Paulo, Brazil. ParticipantsMedical and surgical patients who received physiotherapy (N=181) assessed in 339 physiotherapy sessions.Interventions:Not applicable. Main Outcome MeasuresThe study investigator followed physiotherapists during their work shift and timed the physiotherapy session's length with a stopwatch. The association between session length and patient, physiotherapist, and service-related factors was evaluated by a mixed model. ResultsAssessed in this study were 339 physiotherapy sessions during 79 periods of observation that involved 181 patients and 19 physiotherapists. Median session length was 29 (interquartile range: 22.6-38.9) minutes; median number of patients assisted per physiotherapist per 6-hour shift was 5 (4-5). Physiotherapist's median age was 35 (26-39) years old, and median ICU experience was 13.0 (0.4-16.0) years. Patients were mostly older adults who were post surgery and had been at the ICU for 5 (2-9) days. Factors associated with physiotherapy session length (min) were the following: performing both motor- and respiratory-related physiotherapy procedures during the session (β=6.5; 95% confidence interval [CI], 3.8-9.2), altered chest x-ray (β=2.8; 95% CI, 0.3-5.3), ICU mobility scale (IMS) (β=1.2; 95% CI, 0.4-2.0), contraindication to any level of out-of-bed mobilization (β=–6.9; 95% CI, –10.5 to –3.3), afternoon shift (β=–4.0; 95% CI, –6.7 to –1.4), and Barthel index (β=–0.2; 95% CI, –0.3 to –0.1). ConclusionsThe factors associated with longer session lengths were performing both motor- and respiratory-related physiotherapy procedures during the session, altered chest x-ray, and the IMS. Contraindication to any level of out-of-bed mobilization and sessions performed during the afternoon shift (vs the morning shift) were associated with shorter session lengths.

Sleep Quality among Saudi Nurses: Cross-Sectional Study

Background: Sleep quality is one of the important aspects among nurses as it has a significant impact on nurses’ work productivity, and work quality and is found to be associated with quality of life for nurses. Purpose: This study aims to assess the sleep quality among Saudi nurses. Method: This cross-sectional study included 323 Saudi nurses to measure their sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Results: The study included 75% female and 25% male, with an advantage for age 25-34 (36.9%). The majority (61.61%) held a bachelor's degree in nursing, 49.11% were unmarried, 46.73% were married, 56.55% had fixed morning shifts, and 43.45% had shift days. 27.08% of participants had experienced 10 to 20 years of working experience. The study found that 67.86% had moderate sleep difficulty, followed by mild sleep difficulty, while only 2.08% had severe sleep difficulty. In addition, It was found that female (176.9) was significantly higher than male (143.3) in sleep difficulty (U=8467, p&lt;0.01=0.002). It was found the distribution is significantly different in terms of age (X2=10.52, p&lt;0.05=0.02), and the post hoc (pairwise test) found that the 25-34 group (185.81) was higher than the 35.44 group (143.79). It was found that shift day (189.32) was significantly higher than Fixed morning shift (152.5) in sleep difficulty (U=1083.5, p&lt;0.01=0.006). It was found that female (176.9) was higher than male (143.3) in sleep difficulty (U=8467, p&lt;0.01=0.006). Conclusion: This study examined Saudi nurses' sleep difficulties and related factors in a specific healthcare setting. The findings highlight sleep difficulties and their causes in this population. The study findings emphasize the need to treat sleep difficulties among Saudi nurses to improve their well-being and job effectiveness. Healthcare organizations should promote sleep hygiene and provide sleep management resources. This may involve mental health education, scheduling changes, and support.

Justification of Urgent Brain CT scans at Palestinian Government Hospitals

CT In cases of mild brain injury emergencies, CT scans can be valuable. However, misuse can result in radiation exposure and increased costs. This study examines CT scan utilization in Palestinian government hospitals, using a comprehensive multi-hospital analytical approach. It involved 66 emergency doctors and residents from Darwish Nazzal, Al Hussein, and Palestine Medical Complex. Findings indicate disparities in CT scan ordering practices among emergency physicians. Only 33.3% adhere to recommended guidelines, while 10.6% request scans for non-medical reasons. A lack of awareness regarding radiation exposure is seen in 39.4% of clinicians. Moreover, there are variations in image interpretation and ordering practices between morning and night shifts. Cost concerns are expressed by 68.2% of doctors, and 14.5% of CT scans were unjustified, often due to vague requests. This study underscores the importance of educating clinicians on radiation risks and promoting adherence to current CT scan criteria. Local guidelines and checklists are needed to justify CT scans, and physicians should participate in seminars on radiation doses and maximum allowable levels to reduce unnecessary scans. The hiring of night-shift radiologists in public hospitals is also recommended to enhance patient records and reduce costs.

Levels and Factors of Nurses' Alarm Fatigue in Critical Care Settings in Saudi Arabia: A Multicenter Cross-Sectional Study.

A continuous and high frequency of alarms from monitoring and treatment devices can lead to nurses' sensory exhaustion and alarm fatigue in critical care settings. The purpose of this study was to evaluate the level of alarm fatigue and determine the relationship between nurses' sociodemographic and work-related factors and the level of alarm fatigue in critical care settings in Hail City, Saudi Arabia. Between May and July 2023, 298 nurses who worked in the emergency, intensive care, and critical care units of all the public hospitals in Hail City participated in a cross-sectional survey. Sociodemographic and work-related sheet and the Nurses' Alarm Fatigue Questionnaire were used to collect data. The total mean score of alarm fatigue was 26.38±8.30 out of 44. The highest score was observed for the item "I pay more attention to the alarms in certain", while the lowest score were observed for the items "I turn off the alarms at the beginning of every shift" with mean scores of 2.51 and 1.61, respectively. Nurses who were males, older than 30 years and Saudi citizens had significantly higher mean scores of alarm fatigue than their counterparts. In addition, significantly higher mean scores of alarm fatigue were noticed for nurses experienced for 10 years or more and who had regular morning shifts. Multiple linear regression showed that male (p=0.014), age (p=0.012), and Saudi nationality (p <0.029) were the independent factors affecting the level of fatigue alarm among nurses. Nurses working in critical care settings at hospitals in Hail city are exposed to average levels of alarm fatigue, which can be influenced by sex, age, nationality, and experience of nurses. Therefore, it is imperative to manage alarm fatigue in critical care units by considering work-related and personality-related factors to ensure patient safety.

The Relationship between Patient Load and Nursing Staffing Strength in Various Shifts of the Day in Emergency Department of a Major Tertiary Care Hospital in India

Abstract Introduction A hospital has to function 24 hours a day, which makes shift duties almost inescapable for the nurses. However, shift wise staffing of nursing in emergency departments (EDs) of most hospitals continues to parallel that of other clinical departments. Objective The aim of this study was to see the adequacy of staffing in reference to patient load in the different shifts of the day in the ED of a major tertiary care hospital in India. Methods This is a prospective cross-sectional study. The number of patients entering the ED in each shift as well as the number of nurses assigned in each shift were taken from the rotation over a period of 1 week. A single point questionnaire was also administered to all five nurses in each shift over the study period to assess staff perception of patient load in the shift. Ethics approval was taken from institutional ethics committee. Results For calculating the differential patient load in different shifts. We have calculated the average number of registered patients entering the emergency in over 1 week was 24 in the morning shift, 24 in the evening shift, and 81 in the night shift. The average nursing strength was 11 in morning shift, 11 in the evening shift, and 10 in the night shift. The average response from 15 nurses after interviewing them was 1 (overstaffed) in the morning, 2 (properly staffed) in the evening shift (properly staffed), and 4 in the night shift. Conclusion The ratio of registered patients entering the emergency and the number of nurses deployed in each shift does not match, which gives an important view to revise roster in such a way that will not compromise the patient care.

Massive transfusion protocol reactivation as a novel marker of physician team under-triage after injury.

Large trauma centers have protocols for the assessment of injury and triaging of care with attempts to over-triage to ensure adequate care for all patients. We noted that a significant number of patients undergo a second massive transfusion protocol (MTP) activation in the first 24 h of care and conducted a retrospective cohort study of patients involved over a 3-year period. Transfusion service records of MTP activations 2019-2021 were linked to Trauma Registry records and divided into cohorts receiving a single versus a reactivation of the MTP. Time of activation and amounts of blood products issued were linked to demographic, injury severity, and outcome data. Categorical and continuous data were compared between cohorts with chi-squared, Fisher's, and Wilcoxan tests as appropriate, and multivariable regression models were used to seek interactions (p < .05). MTP activation was recorded for 1884 acute trauma patients over our 3-year study period, 142 of whom (7.5%) had reactivation. Factors associated with reactivation included older age (46 vs. 40 years), higher injury severity score (ISS, 27 vs. 22), leg injuries, and presentation during morning shift change (5-7 a.m., 3.3% vs. 7.7%). Patients undergoing MTP reactivation used more RBCs (5 U vs. 2 U) and had more ICU days (3 vs. 2). Older patients and those presenting during shift change are at risk for failure to recognize their complex injury patterns and under-triage for trauma care. The fidelity and granularity of transfusion service records can provide unique opportunities for quality assessment and improvement in trauma care.

Assessing the Feasibility of a Multifaceted Intervention Package for Improving Respiratory Health of Textile Workers: Findings From the MultiTex Pilot Study in Karachi, Pakistan.

We piloted the development and implementation of a multifaceted intervention package for improving respiratory health among textile workers using a pre-post design at six mills in Karachi. The intervention, implemented following a baseline survey (n = 498), included health and safety training of workers and managers, promotion of cotton dust control measures, and the provision of facemasks. Follow-up surveys were conducted at 1, 6, and 12 months post-intervention. Knowledge, attitude, and practice (KAP) scores and respiratory symptoms were assessed through a questionnaire and spirometry was conducted. The intervention was provided to 230 workers and led to an improvement in KAP scores that was more likely among workers with a higher educational status, spinners, smokers, those with a permanent employment status, working in morning shifts, and with ⩾5 years of textile experience. We found the intervention acceptable and feasible in these textile mills henceforth, trials are required to determine its effectiveness.

Pengaruh Shift Kerja terhadap Stres Kerja pada Lima Orang Karyawan PT Asam Jawa, Kota Pinang

The Occupational Health and Safety Branch (2008) explains that optimizing work shift arrangements can help reduce the potential health impacts on employees. Shift work involves various schedules and work patterns, and its arrangement must take into account a number of factors, such as the length of the shift or the number of hours worked per shift, team size, rest breaks, rotation periods or speed, and shift timing. The aim of this research is to determine the influence of shift work on the stress levels of PT Pegawai Asam Jawa employees in Kota Pinang, and whether there is a relationship between shift work variables and employee stress at PT Asam Jawa in Kota Pinang, using qualitative methodology. This study involved 114 participants. The research indicates that although morning shift workers do not experience high levels of stress, night shift workers do, resulting in decreased overall productivity in the afternoon and evening. Worker performance, health, and psychosocial issues are the subjects of these complaints. Except for night shift workers who complain of being less focused due to poor quality, there are no physical complaints experienced by morning shift workers and night shift workers in terms of body complaints, so the impact of shift work on employee stress can be observed.

Faktor Faktor Yang Berhubungan Dengan Kelelahan Kerja Pada Tenaga Kerja Bongkar Muat (TKBM) Unit Pengantongan Pupuk di Pelabuhan Tanjung Emas Semarang Tahun 2022

When a person experiences fatigue due to work, the body’s physical and mental abilities tend to decrease which causes workers to be less careful when working. Fatigue due to work contributes 50% to work accidents. The purpose of this study was to analyze the relationship between age, nutritional status, length of work and workload with work fatigue in the loading and unloading workers at the Fertilizer Packing Unit at Tanjung Emas Port Semarang.This research is a quantitative research with a cross sectional design. Fatigue data was collected using a reaction timer, workload was measured using a Nasa- TLX questionnaire, nutritional status was measured using a weight scale dan microtoise , while age and years of service were measured using a questionnaire. The sample in this study amounted to 58 morning shift respondents who were taken with a simple random sampling method. Data analysis using Rank Spearman Test Based on the result of univariate analysis, it is known that the majority of respondents are 36-49 years old (43,1%). The most nutritional status was obesity, which amounted to 48,3%, some respondents had worked less than 15 years (55,2%). Most of the respondents experienced a high workload of 60,3%, the majority of respondents experienced work fatigue, heavy work fatigue with a total of 72,4%. Based on the results of the Rank Spearman test, there is a relationship between age and work fatigue with a result of p=&lt;0,001, there is no relationship between nutritional status and work fatigue with a result of p=0,231, there is a relationship between work period and work fatigue with a result of p=&lt;0,001, there is a relationship between workload with work fatigue with the result p=&lt;0,001.