The Population Health Concern

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The Population Health Concern

It may seem to you that healthcare has been a national topic of debate among political leaders for as long as you can remember.

Healthcare has been a policy item and a topic of debate not only in recent times but as far back as the administration of the second U.S. president, John Adams. In 1798, Adams signed legislation requiring that 20 cents per month of a sailor’s paycheck be set aside for covering their medical bills. This represented the first major piece of U.S. healthcare legislation, and the topic of healthcare has been woven into presidential agendas and political debate ever since.

As a healthcare professional, you may be called upon to provide expertise, guidance and/or opinions on healthcare matters as they are debated for inclusion into new policy. You may also be involved in planning new organizational policy and responses to changes in legislation. For all of these reasons you should be prepared to speak to national healthcare issues making the news. The Population Health Concern

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In this Assignment, you will analyze recent presidential healthcare agendas. You also will prepare a fact sheet to communicate the importance of a healthcare issue and the impact on this issue of recent or proposed policy.

To Prepare:

  • Review the agenda priorities of the current/sitting U.S. president and the two previous presidential administrations.
  • Select an issue related to healthcare that was addressed by each of the last three U.S. presidential administrations.
  • Reflect on the focus of their respective agendas, including the allocation of financial resources for addressing the healthcare issue you selected.
  • Consider how you would communicate the importance of a healthcare issue to a legislator/policymaker or a member of their staff for inclusion on an agenda. The Population Health Concern

The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page Fact Sheet)

Part 1: Agenda Comparison Grid

Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the two previous presidential administrations and their agendas related to the public health concern you selected. Be sure to address the following:

  • Identify and provide a brief description of the population health concern you selected and the factors that contribute to it.
  • Describe the administrative agenda focus related to the issue you selected.
  • Identify the allocations of financial and other resources that the current and two previous presidents dedicated to this issue.
  • Explain how each of the presidential administrations approached the issue.

(A draft of Part 1: Agenda Comparison Grid should be posted to the Module 1 Discussion Board by Day 3 of Week 1.) The Population Health Concern

Part 2: Agenda Comparison Grid Analysis

Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following:

  • Which administrative agency would most likely be responsible for helping you address the healthcare issue you selected?
  • How do you think your selected healthcare issue might get on the agenda for the current and two previous presidents? How does it stay there?
  • Who would you choose to be the entrepreneur/ champion/sponsor of the healthcare issue you selected for the current and two previous presidents? The Population Health Concern

Part 3: Fact Sheet or Talking Points Brief

Based on the feedback that you received from your colleagues in the Discussion, revise Part 1: Agenda Comparison Grid and Part 2: Agenda Comparison Grid Analysis.

Then, using the information recorded on the template in Parts 1 and 2, develop a 1-page Fact Sheet or Talking Points Brief that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. You can use Microsoft Word or PowerPoint to create your Fact Sheet or Talking Point Brief. Be sure to address the following:

  • Summarize why this healthcare issue is important and should be included in the agenda for legislation.
  • Justify the role of the nurse in agenda setting for healthcare issues.

By Day 3 of Week 1

Submit a draft of Part 1: Agenda Comparison Grid to the Module 1 Discussion Board

Considering the feedback you received in the Module 1 Discussion on Part 1: Agenda Comparison Grid, revise and further develop Part 1: Agenda Comparison Grid and Part 2: Agenda Comparison Grid Analysis. Consider how the feedback you received might influence your Fact Sheet or Talking Points and revise as necessary.

By Day 7 of Week 2

Submit your final version of Part 1: Agenda Comparison Grid, Part 2: Agenda Comparison Grid Analysis, and Part 3: Fact Sheet or Talking Points Brief. The Population Health Concern

Reflection Paper

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Reflection Paper

The IOM published report, “Future of Nursing: Leading Change, Advancing Health,” makes recommendations for lifelong learning and achieving higher levels of education.

In 1,000-words, examine the importance of nursing education and discuss your overall educational goals.

Include the following: Reflection Paper

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1. Discuss your options in the job market based on your educational level.

2. Review the IOM Future of Nursing Recommendations for achieving higher levels of education. Describe what professional certification and advanced degrees (MSN, DNP, etc.) you want to pursue and explain your reasons for wanting to attain the education. Discuss your timeline for accomplishing these goals.

3. Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.

4. Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics.

5. Discuss whether continuing nursing education should be mandatory. Provide support for your response.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  Abstract and wrap up conclusion are necessary Reflection Paper.

Assignment: Evidence-Based Practice Change

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Assignment: Evidence-Based Practice Change

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question 

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study)Assignment: Evidence-Based Practice Change.

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Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

General Requirements

Prepare this assignment according to the APA guidelines found in the APA Style Guide. An abstract is not required Assignment: Evidence-Based Practice Change.

Article Paper For Intervention Presentation On Diabetes

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Article Paper For Intervention Presentation On Diabetes

This is a Collaborative Learning Community (CLC) assignment.

As a group, identify a research or evidence-based article published within the last 5 years that focuses comprehensively on a specific intervention or new treatment tool for the management of diabetes in adults or children. The article must be relevant to nursing practice.

Create a 4 slide PowerPoint presentation on the study’s findings and how they can be used by nurses as an intervention. Include speaker notes for each slide and references.

Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000621/

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Include the following: Article Paper For Intervention Presentation On Diabetes

1. Describe the intervention or treatment tool and the specific patient population used in the study.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance Article Paper For Intervention Presentation On Diabetes.

The Use Of Clinical Systems To Improve Outcomes And Efficiencies

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The Use Of Clinical Systems To Improve Outcomes And Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

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To Prepare: The Use Of Clinical Systems To Improve Outcomes And Efficiencies

  • Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
  • Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
  • Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

  • Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
  • Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples The Use Of Clinical Systems To Improve Outcomes And Efficiencies.

Evaluation Of Workplace Civility Discussion Paper

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Evaluation Of Workplace Civility Discussion Paper

Clearly, diagnosis is a critical aspect of healthcare. However, the ultimate purpose of a diagnosis is the development and application of a series of treatments or protocols. Isolated recognition of a health issue does little to resolve it.

In this module’s Discussion, you applied the Clark Healthy Workplace Inventory to diagnose potential problems with the civility of your organization. In this Portfolio Assignment, you will continue to analyze the results and apply published research to the development of a proposed treatment for any issues uncovered by the assessment. Evaluation Of Workplace Civility Discussion Paper

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To Prepare:

· Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).

· Review the Work Environment Assessment Template.

· Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.

· Select and review one or more of the following articles found in the Resources:

· Clark, Olender, Cardoni, and Kenski (2011)

· Clark (2018)

· Clark (2015)

· Griffin and Clark (2014)

 

The Assignment (3-6 pages total): Evaluation Of Workplace Civility Discussion Paper

Part 1: Work Environment Assessment (1-2 pages)

· Review the Work Environment Assessment Template you completed for this Module’s Discussion.

· Describe the results of the Work Environment Assessment you completed on your workplace.

· Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.

· Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

· Briefly describe the theory or concept presented in the article(s) you selected.

· Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.

· Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

· Recommend at least two strategies, supported in the literature that can be implemented to address any shortcomings revealed in your Work Environment Assessment.

· Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment. Evaluation Of Workplace Civility Discussion Paper

REFERENCES:

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

· Chapter 5, “Collaborative Leadership Contexts: Networks, Communication, Decision Making, and Motivation” (pp. 121–144)

· Chapter 9, “Creating and Shaping the Organizational Environment and Culture to Support Practice Excellence” (pp. 247–278)

· Chapter 10, “Building Cohesive and Effective Teams” (pp. 279–298)

Select at least ONE of the following:

1. Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4

2. 2. Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator. doi:10.1097/NNE.0000000000000563

3.

 

4. Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

 

5. Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542. doi:10.3928/00220124-20141122-02 Evaluation Of Workplace Civility Discussion Paper

ETHNIC GROUPS

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Because my windshield survey is focused more on older caucasian, asian neighborhood, please try to use any issues among these groups. Heart disease, falls, etc. This is a discusson board post.

Use the required readings for this unit, the Capella University Library, or the Internet to locate a peer-reviewed article describing a study evaluating an ethnic group and its health disparities. Make sure that your peer-reviewed article is not more than five years old, as you want to look at the most current evidence available.

In your posting:

  • Identify the ethnic group and its health disparity.
  • Describe the epidemiological concepts, data analysis methods, tools, and databases used in the study.
  • Evaluate the ethnic group’s contributions to the study.
  • Summarize the study and its conclusions.

Your initial posting should be at least 150 words, and you must reference the work of another writer (either as a quotation, paraphrase, or summary) to provide support for your ideas. The source can be the course text, another relevant book, any assigned reading, or an article you find on your own through the Capella University Library. When you incorporate the other writer’s ideas in your work, use APA citation style to give credit to that writer. Remember that an APA citation includes both the in-text citation (the author’s last name and the year of publication) and the full reference for the source.

Workplace Environment Assessment

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Workplace Environment Assessment

  • Review the Resources and examine the Clark Healthy Workplace Inventory, found on page 20 of Clark (2015).
  • Review the Work Environment Assessment Template.
  • Reflect on the output of your Discussion post regarding your evaluation of workplace civility and the feedback received from colleagues.
  • Select and review one or more of the following articles found in the Resources:

The Assignment (3-6 pages total): Workplace Environment Assessment

Part 1: Work Environment Assessment (1-2 pages)

  • Review the Work Environment Assessment Template you completed for this Module’s Discussion.
  • Describe the results of the Work Environment Assessment you completed on your workplace.
  • Identify two things that surprised you about the results and one idea you believed prior to conducting the Assessment that was confirmed.
  • Explain what the results of the Assessment suggest about the health and civility of your workplace.

Part 2: Reviewing the Literature (1-2 pages)

  • Briefly describe the theory or concept presented in the article(s) you selected.
  • Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.
  • Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams (1–2 pages)

  • Recommend at least two strategies, supported in the literature, that can be implemented to address any shortcomings revealed in your Work Environment Assessment.
  • Recommend at least two strategies that can be implemented to bolster successful practices revealed in your Work Environment Assessment Workplace Environment Assessment.

 

Incivility at the workplace is common in nursing education and clinical practice (Clark, Olender, Cardoni, & Kenski, 2011). Workplace incivility can be defined as repeated offensive, disrespectful, or discouraging behavior, misuse of power, or unfair punishments that make the receiver distressed and feel shamed; creating strain; and decreasing the employee’s self-confidence (Warner, Sommers, Zappa, & Thornlow, 2016). Uncivil behaviors can appear in different forms and may cause profound effects on their recipients.

The work environment assessment of my workplace resulted in a score 35. According to Clark (2015), a score below 50 in the Clark Healthy Workplace Inventory indicates a very unhealthy work environment. It is surprising that two statements where the organization scored the highest were those that stated individuals and collective achievements are celebrated and publicized ; and that use of effective conflicts resolution skills, (Clark, 2015). The publicity and celebration of individual and collective achievements is a new thing that has just been initiated and we are going strong with it. The staffs are vastly knowledgeable on conflicts resolutions. The organization is neutral on communication, living by shared vision and employee are treated in fair and respectful manner.  Somewhat untrue about communication.  The organization scored low in all other aspect of the assessment. Workplace Environment Assessment

Going by this score form Workplace assessment, I will say the organization is a very unhealthy place. We discuss this almost every day with other staff in my department.  Unhealthy place is not safe for both staff and even patients Communication is very poor. Nobody has the idea of when decisions are made which means staffs are excluded from decision making. The staff feels that Patient’s acuity is not put into consideration before staffing is made which made the workload voluminous and makes the environment unsafe. Staff from other departments with no basic knowledge of crisis prevention intervention are been thrown to the psychiatry units.  The staff doesn’t feel supported by the management. The organization is not able to retain staff because the salary is not competitive enough and are not true to their words in terms of benefits, so there is very high turnover of staff. Only few staff has stayed for more than 2 years. Most new staff leaves between 2 weeks and 6 months.

One occasion of incivility that I have experienced was when the supervisor spoke to me in a disrespectful manner because one unidentified person called from ER and asked if we had an extra mental health worker and I responded no. She said I was being unfair and there is a reason while they called for a help. I requested to speak to her in the staff room with one other staff that was with me when the call came in .  She apologized after I had expressed myself because we were never staff with an extra staff.  I couldn’t have sent any staff to ER because I have an agency staff working with me who does know these patients. I could have created an unsafe place for patient and the staffs  when we were already short staff and an agency staff?.

To create a high-performance team, implementation of strategies to improve work environment safety is necessary . To create an even stronger work team, it is vital that establishing excellent communication between employees be present in the organization. Respect and professional communication in a healthcare organization produces improved outcomes for patients and more civil employees (Griffin & Clark, 2014)Workplace Environment Assessment.

References

Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18-23. Retrieved fromhttps://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leaders perspective. The Journal of Nursing Administration, 41(7/8), 324-330. doi:10.1097/NNA.0b013e31822509c4

Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535-542. doi:10.3928/00220124-20141122-02

Warrner, J., Sommers, K., Zappa, M., & Thornlow, D. (2016). Decreasing workplace incivility. Nursing Management, 47(1), 22-30. doi: 10.1097/01.NUMA.0000475622.91398.c3 Workplace Environment Assessment

Essentials Informatics Self-Assessment

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Essentials Informatics Self-Assessment

Purpose

This week’s graded discussion topic relates to the following Course Outcome (CO).

  • CO2 Analyze data from all relevant sources, including technology, to inform the delivery of care. (PO 2)

Discussion

Download and open the AACN Essentials Self-Assessment. (Links to an external site.) Complete the self-assessment of your current comfort levels and total your score. If you are willing, please share your results with your classmates in your discussion post. (Remember, this is the starting point for our course and the start of the knowledge we will learn over 8 weeks).

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As you reflect on your score, identify areas where your knowledge could use improvement. Whether you are a new graduate or a seasoned nurse, it is important to keep in mind that all professional nurses are knowledge workers. Utilizing the readings from your textbook, describe your current knowledge base in informatics and how you can improve your knowledge as they relate to nursing informatics and AACN essential. What additional questions do you have as they relate to nursing informatics and the AACN essentials?

Quantitative Correlational Study’s Research Paper

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Quantitative Correlational Study’s Research Paper

Answer the following questions and reply to at least two colleagues:

  • For the instructor assigned article this week, what research approach (basic vs. applied) is used in the study?
  • What is the specific type of the research method, qualitative or quantitative? Why do you think the author(s) choose this method? What is the specific research design for
    this study? Give a rationale for why you think the author(s) chose this design.
  • What other type of research design could be used for a study about this topic? Why would you choose to study the topic this way? Quantitative Correlational Study’s Research Paper

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Post your initial response by 2359 Wednesday of Module 2  Posts must be substantive and reflect thought and effort in the discussion. Always remember to cite and reference your resources appropriately using APA format.  You should be using in-text citations in your initial response.  Use in-text citations as needed in your replies.

OBJECTIVE: The aim of this study is to explore the relationship between reported sleep, perceived fatigue and sleepiness, and cognitive performance. BACKGROUND: Although evidence suggests that fatigue and sleepiness affect the provision of care in inpatient units, there is a lack of research on the sleep patterns of emergency nurses and the effects of dis- turbed sleep and fatigue on their cognitive abilities and susceptibility to medical errors. METHODS: A quantitative correlational design was used in this study; in each of 7 different statistical models, zero-order relationships between predictors and the dependent variable were examined with appropriate inferential tests. RESULTS: Participants reported high levels of sleepiness and chronic fatigue that impeded full functioning both at work and at home. CONCLUSIONS: Although high levels of self-reported fatigue did not show any effects on cognitive function, other factors in the environment may contribute to delayed, missed, or inappropriate care. Further research is indicated. Quantitative Correlational Study’s Research Paper

Studies of worker fatigue in the military and com- mercial trucking industries1,2 suggest that long hours, especially extending into overnight, can be hazardous in terms of the potential for errors due to sleepiness and reduced vigilance. Medical providers, both nurses and physicians, are at risk because of the need for around-the-clock coverage and the number and type of decisions they must make in a given time span; in 1989, the Bell Commission Report cited sleep depri- vation in medical house officers as a major contrib- utor to the 1984 death of Libby Zion, an 18-year-old who died at New York Hospital, leading to a restruc- turing of the hours involved in medical residencies.3

The long (up to 36 hour) shifts of the medical resi- dents in charge of her care and the consequences of their fatigue on the decisions that were made were cited as factors in her death. As a result of their inves- tigation of the case, the Bell commission recommen- ded limiting the work hours of medical residents to less than 80 hours a week and no more than 24 hours in a row, and subsequent research has led to similar recommendations for the nursing workforce.4,5

Emergency care settings are chaotic environ- ments, where there is high patient turnover, constantly changing priorities and frequent changes in patient condition. High demand work settings are associated with increased fatigue, which can impair nurses_ at- tentiveness and ability not only to recognize potential errors they might commit but also to recognize and mitigate the errors of others, including physicians.6,7

The work schedules of emergency nurses (ENs) are characterized by increasing demands, irregular shifts, and long hoursVall of which challenge their mental and physical stamina. Although 12-hour shifts are

JONA � Vol. 47, No. 1 � January 2017 41 Quantitative Correlational Study’s Research Paper

Author Affiliations: Director, Institute for Emergency Nursing Research (Dr Wolf); Senior Research Associate (Mss Perhats and Delao), Emergency Nurses Association, Des Plaines; and Research Assistant Professor (Dr Martinovich), Department of Psychiatry, Northwestern University Feinberg School of Medicine, Evanston, Illinois.

The authors declare no conflicts of interest. Correspondence: Dr Wolf, Institute for Emergency Nursing

Research, Emergency Nurses Association, 915 Lee St, Des Plaines, IL 60016 (lisa.wolf@ena.org).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal_s Web site (www.jonajournal.com).

DOI: 10.1097/NNA.0000000000000435

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

common, nurses frequently work additional hours; work days may last 16 hours or more, often spread- ing across evenings and nights with short intervals between shifts. More than a decade ago, Rogers et al8

presented compelling evidence of increasing incident/ error rates during extended periods of work: Rates rise after 9 hours, double after 12 consecutive hours, and triple by 16 hours. Further studies have demon- strated that insufficient sleep and inadequate recov- ery time from long hours and shift work affect a nurse_s ability to provide safe, effective patient care and increase risks to personal safety.9-11 The Joint Commission_s 2011 Sentinel Event Alert on health- care worker fatigue and patient safety states that BShift length and work schedules have a significant effect on healthcare providers” quantity and quality of sleep and, consequently, on their job performance, as well as on the safety of their patients and their individual safetyIStill, while the dangers of extended work hours (912 hours) are well known, the healthcare industry has been slow to adopt changes, particularly with regard to nursingI[12(p1) Multiple studies support that a significant number of inpatient nurses have im- paired sleep quality, excessive sleepiness, and abnormal fatigue, which are associated with a greater risk of making medical errors and potentially causing harm to patients.13-15 The research of Rogers and colleagues8 Quantitative Correlational Study’s Research Paper

demonstrated that the 12-hour shift is past the point where safe decision making may be expected, and both the Agency for Health Research and Quality4

and the Institute of Medicine5 have since recommended limiting the length of nurses_ shifts. Although evidence suggests that both mental and physical fatigue and sleepiness affect the provision of care in inpatient units,16 there is a lack of research on the sleep patterns of ENs and the effects of disturbed sleep and fatigue on their cognitive abilities and susceptibility to making medical errors. The purpose of this study is to explore the relationship between reported sleep quality, per- ceived fatigue and sleepiness, and cognitive perfor- mance in a sample of ENs.

Methods

Before recruitment of subjects, institutional review board approval was obtained and the study was approved (Chesapeake Research Review, Columbia, Maryland). A Certificate of Confidentiality from the National Institutes of Health was obtained to further protect the respondents_ anonymity given the sensi- tive nature of the question. A quantitative correla- tional design was used to explore the relationship between nurses_ reported sleep patterns, perceived sleepiness and fatigue, and their ability to carry out timed cognitive tasks. As part of a 35-item online

questionnaire, participants performed 3 medication dosage calculations and correlations between fatigue and cognitive performance were measured in the same survey. Predictors were selected based on empirically based associations with work fatigue and its impact on task performance.17 In each of 7 different statistical models, zero-order relationships (ie, simple relationships that do not hold constant other predictors) between each of the predictors and the dependent variable were examined with appro- priate inferential tests.

Sample

Of the 2,419 ENs who were recruited via e-mail and social media, 2010 met eligibility criteria and consented to participate. Eligibility criteria required that study participants were English speaking, currently licensed ENs working at least 1 shift per week in a US emergency department (ED). Among those who consented, 504 survey respondents were excluded because they did not meet study criteria (eg, worked 1 shift or less in the past 30 days, did not complete survey in 1 sitting), resulting in a total sample of 1506 ENs Quantitative Correlational Study’s Research Paper