D. Gail Shorter, DNP(c), ANP-BC, CRNP Wilmington University DNP Project

Transcription

1 D. Gail Shorter, DNP(c), ANP-BC, CRNP Wilmington University DNP Project

2 Peer group of nurses, identified as Baby Boomer generation Self-reporting of increases in chronic and acute health conditions Scope Determining if an educational program (either inperson or an asynchronous LMS offering) that defines the phenomenon, shows connections to health and to middle aged nurses, offers evidence-based interventions and suggests a framework for successful change can affect nurses to contemplate behavior changes Present and test this measure in a rural hospital system.

3 Program development and evaluation The intervention will be the creation of educational programs to: increase awareness of the phenomenon among nurses in all age groups to promote wellness, prevent disease and encourage a culture of peer support alert nurse leaders to issues that can impact quality, safety and increasing employee healthcare expenses offer strategies for better behaviors and successful selfcare implementation Post-Test/Pre-Test data will measure/evaluate knowledge of topic and willingness to implement behavior change

4 Will providing Baby Boomer (BB) nurses with: the knowledge that chronic sleep deficit of shiftwork sleep disorder/insomnia has been shown to increase risks for many chronic diseases sleep hygiene interventions that have been identified to ameliorate sleep deficit a framework to assist individuals to make changes to improve and maintain self-care behaviors. lead to a commitment to change behaviors?

5 PROJECT OBJECTIVES Using either a live or enduring material continuing education contact hour program, present information on this topic to staff nurses and nurse leaders Continue to interject the topic of shiftwork, sleep deficit and nursing health into conversations with nurses, nurse leaders and HR leaders Submit abstract for podium presentation on topic to MNA 2015 Convention Submit letter of inquiry to nursing journal EVALUATION MEASURES Post-test/Pre-test evaluation method for to evaluation knowledge and increase in willingness to change behaviors and separate contact hour program evaluation on content and speaker Observations of change in policy, resources for shift workers and personal health habits Abstract acceptance Article acceptance

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7 Multiple studies highlight the mechanisms for circadian rhythms related to the strong physiologic urge to sleep at designated times in the 24 hour cycle. Literature on circadian rhythm sleep disorders, including shiftwork sleep disorder and insomnia have shown connections between sleep deficits and increased risk for numerous disease processes.

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10 JET LAG

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12 Insomnia Excessive sleepiness as a result of a work schedule that takes place during the normal sleep period

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14 Immediate effects - can be seen as stress, fatigue, negative mood, discomfort, physiologic dysfunction, and poor health behaviors (overeating, smoking, and lack of exercise). Long-term effects

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18 Baby boomers (50-68) are >26% of population. NHANES database and Baby Boomers (BB) Longer life expectancy than previous generations, but they also have higher rates of chronic disease, more disability, and lower self-rated health than their parents and grandparents at the same age. (King, Matheson, Chirina, Shankar, & Broman-Fulks, 2013) As individuals age, working shifts in opposition to normal body rhythms can have increasing impact on health and quality of life

19 Nurses a vulnerable population? Group with increased risk of physical, psychological and social health variances Dr. LuAnn Aday Agency of Healthcare Research and Quality Financial The very young and the very old Minority Gender Inability to communicate

20 The RN work year is longer than the national average by over 200 hours Rapid Returns to work Prolonged commuting times Multiple jobs Too many family/community demands Drowsy Driving

21 Nursing as a group is aging. Baby Boomer nurses = almost 1 million of 3.5 million U. S. nurses More studies are focusing on nurses and shift work sleep disorder in relation to health as well as individual and patient safety issues. Few studies focus specifically on Baby Boomers

22 Social Cognitive Theory is the chosen framework to affect change for sleep behaviors in this population. It has been used in several areas of health promotion. Created by Albert Bandura, PhD, and utilizes a/an individual s past success belief that change can occur role models of successful change environmental factors that bear on the ability to make change

23 Social Cognitive Theory

24 Cognitive Factors Knowing health effects Believing sleep is important Attitudes about needing sleep

25 Sleep researchers are finding evidence of the most effective methods to modulate sleep in shift workers

26 Dark /Light Balance Use caffeine wisely Exercise Nutrition Setting limits Naps Meds Setting limits Dark/Light Balance Nutrition Exercise Routine sleeping hours Melatonin Meds

27 Average direct and indirect costs for younger adults ( < age 65) with insomnia were about $1,253 greater than for patients without insomnia (Ozminkowski, Wang, & Walsh, 2007, p. 263) Fifty five to seventy five percent of participants report they do not discuss sleep with their primary care providers, thereby eliminating the possibility of optimal treatment (Obayon, 2002, p. 97)

28 "The World Health Organization has said that SWSD acts as a carcinogen that causes cancer, U.S. Government Dept. of Health and Human Services Healthy People 2020 National Transportation Safety Board American Nurses Association State Boards of Nursing Legal system Media

29 Generational differences in nurses recognition of sleep hygiene and connections to physical and mental health Nursing and Human Resource leaders willingness to change scheduling practices to improve nurse health and /or patient safety. Perceptions of sleep needs of shift workers among their family members Moral distress and sleep deficit among nurses Perception of nurses regarding level of support by nursing leaders and positive self-care behaviors of the nurse

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