Effect of Sleepiness and Fatigue on Nursing Performance among Intensive Care Unit and Coronary Care Unit Nurses inWestBank

An-NajahNational University Faculty of Nursing 2015-2016 Effect of Sleepiness and Fatigue on Nursing Performance among Intensive Care Unit and Coronary Care Unit Nurses inWestBank By Ammar Khalil Mohammad Joori Shoroq Barhoush Malek Diab Supervisor by Dr Mariam Al-Tell Submitted as the requirement for the final project thesis of the bachelor's degree in nursing.Faculty of medicine and health sciences at An-Najah National University, Nablus, Palestine.2015 Acknowledgement First of all we would thanks the GOD then we want to thanks Dr Mariam Al-Tell for her great help and instructions during this course and in our project also we acknowledge Dr ImanShaweesh for her supervision during research and project course We also acknowledge everyone how helped us in working and we thanks our family’s those support us Table Of Contents NO Content II Page 1.1 2.1.1 2.2.1 2.2.1 2.2.2 2.2.3 2.3.1 2.3.2 2.3.3 2.3.4 2.4.1 2.4.2 3.1 3.2 3.3 3.4 3.5 3.6 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8.1 4.8.2 Acknowledgment Table Of Contents List Of Tables List Of Annexes List Of Abbreviations List of Conceptual Definitions Abstract Chapter One: Introduction Introduction Chapter Two Background Sleep Consequences Of Poor Sleep Sleepiness Causes Of Sleepiness Symptoms Of Sleepiness Fatigue Classification Of Fatigue Symptoms Of Fatigue Factors Of Fatigue Nursing Performance Factor Affecting Nursing Performance Chapter Three Literature Review Literature Review Problem Statement Significant Of Study Aims Of This Study &Objective Research Question Hypothesis Chapter Four Methodology Introduction Study Design Site And Setting Study Population Sample Size And Sampling Method Eligibility Criteria Data Collection Tool Validity And Reliability Reviewing By Experts II III VI VIII IX X XI 8 10 11 12 12 15 16 17 28 28 29 29 29 30 31 31 31 31 32 32 32 33 33 4.8.3 4.8.4 4.9 4.10 4.11 Pilot Testing Cronbach’sAlpha Ethical Consideration AdminstrativeAndField Work Data Analysis (Operational Definition) Chapter Five Result 34 34 34 35 35 37 5.1 Participant According To The Demographic Data 38 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 Participant According To Their Pattern Of Work Participant To Their Quality Of Sleep Participants Regarding Their Feeling Of Fatigue Participants According Nursing Performance Participants Regards Their Quality Of Sleep Participants Regards Their Level Of Fatigue Participants According To The Level Of Performance Participants Regards Their Physical Performance Participants Regards Their Metal Performance Hypotheses Result Participants According To Their Level Of Performance In 39 40 41 42 43 43 43 43 44 44 44 5.12 Relation To Their Sleep Quality Participants According To Their Level Of Performance In 45 5.13 Relation To Their Fatigue Level Participants According To Their Level Of Fatigue In Relation To 45 Their Type Of Performance Chapter Six Discussion Discussion Hypotheses Discussion 46 47 50 Chapter Seven 7.1 7.2 7.3 Conclusion And Recommendation And Limitations Of Study Conclusion Recommendation Limitations Of Study References Annxes II 52 53 54 55 56 66 List Of Tables NO Table (4 1) Content Page Distributed Of Number OfNurses According To 31 Table (4 2) Table (4 3) Hospital Location The Result Of Cronbach's Alpha Test The Total Response Rate Of Participant In The Study 34 35 Table (4 3) Variables Of The Study 35 Table (5 1) Distribution Of Percentages Of Participant According 38 Table (5 2) To The Demographic Data Distribution Of Percentages Of Participant According 39 Table (5 3) To Their Pattern Of Work Distribution Of The Percentage Of Participant To Their 40 Table (5 4) Quality Of Sleep Distribution Of Percentage Of Participants Regarding 41 Their Feeling Of Fatigue Table (5 5) Distribution Of Percentages Of Participants According 42 Table (5 6) Nursing Performance Distribution Of Percentage Of Participants Regards 43 Their Quality Of Sleep Table (5 7) Distribution Of Percentage Of Participants Regards 43 Table (5 8) Their Level Of Fatigue Distribution Of Percentages Of Participants According 43 Table (5 9) To The Level Of Performance Distribution Of Percentage Of Participants Regards 43 Their Physical Performance Table (5 10) Distribution Of Percentage Of Participants Regards Their Metal Performance 44 Table (5 11) Distribution Percentage Of Participants According To 44 Their Level Of Performance In Relation To Their Sleep Table (5 12) Quality Distribution Percentage Of Participants According To 45 Their Level Of Performance In Relation To Their Table (5 13) Fatigue Level Distribution Percentage Of Participants According To Their Level Of Fatigue In Relation To 45 Their Type Of Performance List Of Annexes NO Annex(1) Annex(2) Annex (3) Annex (4) Annex (5) Content Questioner In English Psqi Permission Npi Permission Permission From IRB ConcentForm Annex (6) Permission Of MOH Page I VII VIII IX X XII II List Of Abbreviations ICU: Intensive Care Unit CCU:coronary care Unit PMC: palestenian medical complex IRB: Institutional Review Board NPI: Nursing Performance Instrument PSQI: The Pittsburgh Sleep Quality Index FSS: Fatigue Severity Scale WHO: WoridHeaith Organization SPSS: Statistical Package for Social Sciences CNA :Canadian Nurses Association RNAO:Registered Nurses’ Association of Ontario List of Conceptual Definitions Sleep: Is a period of rest for the body and mind, during which volition and consciousness are in partial or complete abeyance and the bodily functions partially suspended Sleep has also been described as a behavioral state marked by characteristic immobile posture and diminished but readily reversible sensitivity to external stimuli “(Medical dictionary, 2007) Sleepiness: As defined by Stoppler (2007)is feeling sleepy at times, when sleepiness interferes with daily routines and bodily functions or shortens the ability to function as a person can be sleepy without realizing it Fatigue: As total body feelings, ranging from tiredness to exhaustion, create an unrelenting overall condition that effect on function and capacity nursesEllis (2008) Also, Schaffner( 2006) defined it as a subjective feeling of tiredness II Intensive care unit: Is a specialized section ofa hospital that provides comprehensive and continuous care for persons who are critically ill and who can benefit from treatment(brilli et al., 2011) Abstract Introduction: Fatigue and sleeplessness is the major problem that has an effect on nursing performance Long work hours and less numbers of nurses and the large number of patients this lead to increase the incidence of fatigue and sleeplessness among the nurses Aim: This study aimed at investigating the effects of fatigue and sleepiness on nursing performance among ICU and CCU nurses in governmental hospitals at west bank Method:Quantitative cross sectional design study was used to achive the aim of the study utilizing a convenience sampling method A self-administration questionnaire was distributed to 175 nurse's work in ICU and CCU in governmental hospital in West Bank; Rafidia and Al-Watany hospital on Nablus, Palestinian medical complex hospital on Ramallah and Alia governmental hospital on Hebron) Results: The result of study concluded that 79.3% of participants have poor sleep, 50.4% of participants have fatigue, and 41.3% of them have good performance In addition there is a relation between performance and sleep, and between fatigue and nursing performance Conclusion:Sleep and fatigue has an effect on nursing performance, In addition the mental performance has major effect on fatigue than physical performance And there was a negatively relation between fatigue and nursing performance Also there was a relation between sleep and nursing performance Recommendation: Help policies to conducting study to investigate other causes affecting sleep and fatigue of nurses, and increasing the number of nurses to ensure care establish scheduling practices and policies for nursing staff Keywards :Sleep , Sleepiness , Fatigue , Nursing Performance , Intensive Care Unit Nurses , Coronary CareUnit Nurses II Exercise brings on my fatigue I am easily fatigued Fatigue interferes with my physical functioning Fatigue causes frequent problems for me My fatigue prevents sustained physical functioning Fatigue interferes with carrying out certain duties and responsibilities Fatigue is among my three most disabling symptoms Fatigue interferes with my work, family, or social life Total Score: Nursing performance This section is use to evaluate nursing performance Please rate the extent to which you agree with the following statements Circle a number from 1-6: “Strongly Disagree” to “Strongly Agree” which best indicates your response Strongly disagree (1) II disagree (2) Slightly Slightly disagree (3) agree (4) Agree (5) Strongly agree (6) 1- During a work shift, Are there any changes in your muscle strength, endurance, or physical energy affect your ability to perform physical tasks associated with your job (e.g., carry items, perform patient handling tasks, walk/drive from patient to patient, etc.)? 2- Are you sometimes find it necessary to take shortcuts in patient care? 3-Are you always apply the "5 Rights" principle when administering medications? 4- Throughout a work shift Are you able to perform fine motor tasks (e.g., inserting an IV, catheter insertion, medication preparation, etc.) without difficulty? 5- During a work shift, Does the changes in your concentration or alertness affect your ability to perform patient monitoring, medication administration, and/or documentation tasks? 6- Are you always able to carry out safe nursing practice 7- During a work shift, Does changes in your mood, mental energy, or attentiveness affect your ability to communicate clearly and effectively (e.g., express my opinions, understand what others are saying, etc.) with other nurses, physicians, clinicians, patients or family members? 8-Are you always follow existing facility or organizational guidelines for safe patient handling (e.g., use of lift devices, two person lifts, etc.)? 9-Are you sometimes forced to modify my standards to get the work done? Annex (2) PSQI permission II Anix (3) NPI permission Annex (4) : permission from IRB II Annex (5) Consent form Study name : Effect of sleepiness and fatigue on nursing performance among ICU nurses in North and Middle West bank Aim of this Study: The study purpose is to investigate if any effects of fatigue and sleepiness on nursing performance The expected duration of the subject's participation: Your participation in this study may take fifty minutes to complete the questionnaire which consist of several items about your thoughts and perception of effects of fatigue and sleepiness on nursing performance About your participation: There is no potential risk from your participation, it doesn’t contain any experiment or intervention, and it’s only a descriptive, exploratory study There is no direct personal benefit, but it can benefit the future nursing profession Be sure that we respect your privacy and all of your information will be kept a secret, and no one have the right to use it except the researchers themselves You can ask the researcher about any information about the questionnaire and any unclear question it may contain Remember that:You have the right to accept or refuse the participation in this study without involving any penalty Researchers names: ShoroqBarhoush, Ammar Khalil, Mohammad Joori, MalekDiab Supervisor of research: Dr Mariam Al-Tell I accept to participate in this study……………………… Signature Date: II When there are any questions you have you can contact: AmmarNimar Ali Khalil :0599255958 Mohammad Joori :0597862528 Annex (6) permission from MOH II ... Poor Sleep Sleepiness Causes Of Sleepiness Symptoms Of Sleepiness Fatigue Classification Of Fatigue Symptoms Of Fatigue Factors Of Fatigue Nursing Performance Factor Affecting Nursing Performance. .. sleepiness on nursing performance Objective : To identify effect of fatigue on nursing performance To identify effect of sleepiness on nursing performance 3.5 Research question are : Dose fatigue. .. 50.4% of participants have fatigue, and 41.3% of them have good performance In addition there is a relation between performance and sleep, and between fatigue and nursing performance Conclusion:Sleep