护士夜班值班时间及排班方式的调查分析

[目的]了解护士对夜班上班、下班时间和夜班排班方式的需求。[方法]根据研究目的设计调查问卷并对全院参与夜班轮班的护士进行抽样调查,用Excel软件进行统计分析。[结果]多数护士同意以07:30,15:30,22:30作为护理3个班次的交接点,74.9%的护士不认同设置夜班专职护士,57.6%的护士同意先中班,后夜班。[结论]充分尊重护士的意见和需求,合理排班,体现以员工为本的人本管理思想。     

对我院护理班次改革前后的满意度调查与分析

目的调查轮班护士对两种夜班方式的满意度,从而制定更为合理的夜班排班方式。方法采用自行设计问卷调查表,对112名工作5年以上轮班护士进行调查。结果轮班护士对改革后夜班方式满意度高于改革前夜班方式,差异具有统计学意义(P<0.01)。结论为改善轮班护士身心健康,提高护理质量,临床护理管理者应尽量采用先小夜班后大夜班的夜班排班方式。     

三线排班在临床护理工作中的实施

目的探讨三线排班方式对护士身心状况及夜间护理质量的影响。方法采用回顾性调查的研究方法,调查我院全面实施三线排班方式前后护理人员的休病假情况及夜班护士对三线排班方式的态度。结果全面实施三线排班方式前后护理人员休病假情况存在统计学差异(P<0.05),实施后休假率明显下降。86.0%的夜班护士认为有必要设立二线值班护士,85.7%的护士认为有必要设立三线值班护士,即夜班护士对三线排班方式基本持肯定态度。结论三线排班方式可全面提高夜班护理质量,有利于护理人员身心健康。     

两班制夜班包月排班模式在老年病房减少交班次数的作用

目的：探讨两班制夜班包月排班模式在老年病房减少交班次数的效果。方法实行一种两班制包月夜班排班模式,即根据护士的工作能力、职称、资历等分为2人一小组,4人一大组,4人包夜班一个月,2人包中班,其他均为责任护士固定白班3个月。在新排班模式实行3个月后,将新旧两种排班模式患者满意度、护士满意度和护理质量进行比较。结果新排班模式患者满意度、护士满意度和护理质量均优于旧排班模式(均P<0.05),其中基础护理和健康教育两项,在两种排班模式下比较,差异有显著统计学意义( P<0.01)。结论两班次排班模式减少交班次数,可提高患者满意度、护士满意度和护理质量,并能较好地防范护理差错和融洽护患关系,有利于护士长的管理和护理质量的持续改进,值得推广。     

供给特定营养素提高夜班护士工作质量的研究

目的 改善频繁夜班对护士身心健康的影响,进一步稳定护理队伍,全面提高护理质量.方法 随机选择临床科室夜班护士60例,分为实验组、对照组各30例,实验组在夜班同定时间段内提供咖啡,对照组夜班期间则不供给;根据康奈尔医学指数(CMI)和特质应对方式问卷,结合本项目需要设计调查表进行问卷调查,并测定肾上腺皮质醇及血糖浓度.结果 实验组兴奋性增强,积极性增高,有消除困倦作用而不影响下班后睡眠,肾上腺皮质醇浓度和血糖浓度上升明显,与对照组比较差异均有统计学意义.结论 通过供给特定营养素,能人为干预、消除夜班护士困倦疲劳状态,降低护理事故发生率,提高护理质量.     

可行性论证方法在护理排班中的应用

目的探讨护理排班的可行性论证方法。方法对外科重症监护中心护理工作量进行调查，根据结果设计新的排班模式，对实施新排班模式前后人力资源的使用情况进行分析，论证其可行性。结果旧的排班方法床边交接班占全部护理工作量的5．12％。日班与夜班工作量之比为1．21：1，而病区排班日班与夜班人力之比为2．57：1。经可行性论证的新排班模式实行后，95．65％的护士反映交接班次数减少、可准时下班、夜班护理质量有保证；84．62％的护士认为有利于连续观察病情、夜班压力减小；80．77％的护士认为人力与工作量之比合理、小夜班不影响睡眠；100．00％的医生认为新排班模式实行后，提高了夜班护理工作质量；81．81％的医生认为夜班护士能及时发现病情变化；72．73％的医生认为能促进医护合作，护士精神面貌好转。结论可行性论证体现了科学排班的原则，保证了护理质量和护理管理的人性化。     

改进护士排班方法的实践与体会

目的改进护士排班方法,提高护理质量。方法采取护士自愿报名,相对固定夜班、白班护士的排班方式。结果护理工作质量达到三级甲等医院标准,服务满意度从原来的90%上升到98%,98%的护士支持排班改进方法。结论改进后的护士排班方法,护士乐于接受,病人满意率增加,同时,缓解了临床护士相对不足的问题,保证了整体护理质量。     

国外护士三班制排班与人力资源利用分析

当前,随着我国以患者为中心的整体护理工作的不断深入,暴露出现行护理排班方式中存在的一些缺陷。结合笔者在新加坡工作2年的体会,对国外护理排班在合理应用人力资源满足患者需要方面进行简要分析。1 国外护理排班方式1.1 护理班次 差别最为明显,各班次的工作时间与我国不同,主要表现在三班的时间分段上,一是护士上早班的时间普遍比医院其他工作人员（管理人员、医生、医技人员等）提前约1h,二是夜班交班比我国要早3～4h,没有小夜班。如法国,早班6:30～14:30;中班13:00～21:30;夜班21:30     

护士夜班排班方式对增加直接护理时数及护理质量的影响

目的探索增加直接护理时数及提高护理质量的护士夜班排班方式。方法根据病房工作量的分类方法,对临床内外科护士三班倒换制、全夜制夜班的间接、直接护理时数统计,比较不同夜班排班方式对直接护理时数及护理质量的影响。结果全夜制夜班对比倒换制夜班护士每24h可增加直接护理时数66min,折算为1.06h,P<0.001;全夜制夜班夜间护理病人综合满意度为95.67%;病区夜间护理质量达标率100%。结论全夜制夜班可减少护士频繁交接班而增加直接护理时数,有利于提高护理效率及护理质量。     

对护士APN排班方式满意度的调查

目的了解护士对APN排班方式的满意度,初步探讨APN排班方式对护士工作及其个人和家庭的影响。方法采用自行设计的护士排班满意度调查问卷以不记名自填式问卷调查法,调查2个科室共51名执业护士对APN排班方式的满意度。经测定,问卷的Cronbach’S＆系数为0．724。结果已婚、本科学历的护士对APN排班方式满意度分别为69．57％、88．89％,高于未婚、专科学历的39．29％和47．62％,差异有统计学意义（x2=4．647,5．098;P均〈0．05）。护士认为APN排班方式使护士之间合作性增加,护患交流机会增多,业余可利用时间增加,夜班心理压力减轻。结论护士对APN排班的满意度较高,较之传统的排班方式,APN排班考虑了轮班工作对护士自身健康、家庭生活及业余学习的影响,更加人件化、科举化。     

Night shift: can a homeopathic remedy alleviate shift lag?

Night shift nurses are subject to shift lag or circadian dysrhythmia, which may result in physical and mental symptoms ranging from fatigue, irritability, depression, and apathy to gastrointestinal, cardiovascular, and sleep disorders. This study investigated the effect a homeopathic remedy No-Shift-Lag had on the night shift nurses in an intensive care unit. The study was a randomized, double-blind, placebo-controlled, crossover trial. The measures included an objective computer-based vigilance test and a series of subjective questionnaires.     

Night duty as an opportunity for learning

Title. Night duty as an opportunity for learning. Aim. This paper is a report of a study to examine what opportunities night nurses have to learn in terms of being able to distinguish variations in the patients’ conditions. Background. Night nurses often lack access to the formalized in‐service training offered to day nurses. As every clinical experience can be seen as an opportunity for learning, learning takes place even at night. However, the learning of night nurses has not been studied previously. Method. This study is based on interviews with a convenience sample of 10 night nurses at a medium‐sized Swedish hospital in 2001. These interviews were reanalysed in 2006 concerning learning situations. The interviews were tape‐recorded, transcribed verbatim, coded and examined using latent content analysis. Findings. There are certain opportunities for learning during the night shift, and three learning situations come to the fore: (1) the report situation, (2) the personal assessment round, where the nurses form their own picture of the patient, (3) in assessment prior to contact with the doctor on duty. Nurses learn from variations in patients’ conditions and when they have to report their experience verbally. Learning does take place at night and gestalt psychology is a helpful tool for understanding how former knowledge and experience affect night nurses’ learning. Conclusion. Knowledge developed during the night shift is a neglected field. There is a need for further investigations of what night nurses learn, and this knowledge ought to be integrated in the body of nursing knowledge.     

二级医院夜班护士睡眠质量现状与影响因素的调查分析

目的了解二级医院夜班护士的睡眠质量及影响因素,为制订管理对策提供依据。方法采用匹兹堡睡眠质量昔表对淮安市8所二级医院581名夜班护士进行调查。结果夜班护士匹兹堡睡眠质量得分高于国内正常成人（P〈0．01）;44．92％的夜班护士存在睡眠障碍;夜班护士睡眠质昔的影响因素为科室和有无二线班（P〈0．O1或P〈0．05）。结论准安市二级医院夜班护士睡眠问题比较突出,应引起社会、有关管理层及护士自身的重视,建议从社会、医院、护士自身方面采取相应的对策。     

Night Shift Work,Genetic Risk,and Hypertension

ObjectiveTo perform a prospective cohort study to investigate whether night shift work is associated with incident hypertension and whether this association is modified by genetic susceptibility to hypertension because evidence on the association between night shift work and hypertension is insufficient.MethodsA total of 232,665 participants of UK Biobank who were recruited from 2006 to 2010 and observed to January 31, 2018, were included in this study. A Cox proportional hazards model with covariate adjustment was performed to assess the association between night shift work exposure and hypertension risk. We constructed a polygenic risk score (PRS) for genetic susceptibility to hypertension, which was used to explore whether genetic susceptibility to hypertension modified the effect of night shift work. The robustness of the results was assessed by sensitivity analysis.ResultsNight shift workers had a higher hypertension risk than day shift workers, which increased with increasing frequency of night shift work (P_trend<.001). The association was attenuated but still remained statistically significant in the fully adjusted model. We explored the joint effect of night shift work and genetic susceptibility on hypertension. Permanent night shift workers with higher hypertension PRSs had higher risk of hypertension than day workers with low PRSs.ConclusionNight shift work exposure was associated with increased hypertension risk, which was modified by the genetic risk for hypertension, indicating that there is a joint effect of night shift work and genetic risk on hypertension.     

Self-reported sleep and health among Norwegian hospital nurses in intensive care units

Aim and background: Shift work, and especially night work, is associated with poor health. Nurses, work a variety of work schedules including night work. So far, few studies have specifically investigated sleep and health among intensive care nurses. Design and methods: We investigated sleep, sleepiness, fatigue, subjective health complaints, anxiety and depression in 150 intensive care nurses (convenience sample representing a response rate of 56·2%). The nurses worked at two major University hospitals in Norway and answered a questionnaire survey. Results: The intensive care nurses reported poorer sleep, more sleepiness, more fatigue, more anxiety and more depression compared to normative data. Poor sleep was reported by 70% and excessive sleepiness by 25% of the nurses; however, the design of the study did not allow us to determine the causes underlying these findings. Multiple linear regression analyses showed that age was positively associated with sleep problems, fatigue, subjective health complaints and anxiety and depression. In contrast, shift work experience was negatively associated with sleep problems, suggesting better coping with shift work over time. Conclusions: Nurses working in intensive care units reported poorer sleep, more sleepiness, more fatigue, more anxiety and more depression compared to Norwegian norm groups. Age was positively related to these complaints, whereas shift work experience was negatively related to poor sleep. More studies are needed on strategies to improve sleep and health in nurses.     

冠心病监护室夜班护士工作应激源的质性研究

目的探索冠心病监护室(coronary care unit,CCU)护士对夜班护理工作的真实体验及感受,了解夜班护士工作应激源,为人性化的护理管理提供依据。方法采用质性研究中的现象学研究法对CCU病区6名夜班护士进行半结构式的深入访谈,探索分析夜班工作的体验。结果 CCU护士夜班工作应激源包括恐惧、失望、劳累、人际关系压力、工作经验欠缺5个主题。结论加强与护士的心理沟通,强化独立值班前的应急训练,运用激励机制和组织的支持系统可以缓解夜班护士工作中的生理与心理应激,提高工作积极性。     

Nursing care at night: an evaluation using the Night Nursing Care Instrument

INTRODUCTION: Night nurses carry overall nursing responsibility for approximately half the time that patients spend in hospital. However, there is a paucity of literature that focuses on nursing care provided at night. AIM: The aim of this study was to evaluate nursing care provided at night from the perspective of both nurses and patients. METHODS: The study, which had an evaluative and a comparative design, was carried out using the Night Nursing Care Instrument at a hospital in southern Sweden. Nurses (n = 178) on night duty were consecutively selected, while the patients (n = 356) were selected by convenience sampling. RESULTS: The results showed a statistically significant difference between nurses' assessments and patients' perceptions of the nursing care provided at night in nursing interventions (P < 0.0001). In the areas of medical interventions and evaluation, no statistically significant differences were found between nurses and patients. For eight of 11 items, patients reported that they were satisfied (> or =80%) with the nursing care provided at night. CONCLUSIONS: These findings suggest that night nurses need to improve their ability to assess patients' needs for nursing care at night. A first step in this direction is for them to become aware of how patients perceive night nursing. As a second step, nurses need to increase their knowledge of which nursing actions promote patients' rest at night.