Sleep, fatigue, and alertness during working hours among rotating-shift nurses in Korea: An observational study.

Abstract

AIMS\nTo determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts.\n\n\nBACKGROUND\nShift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care.\n\n\nMETHODS\nAn observational study using wrist actigraphs was conducted from 2019-2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift.\n\n\nRESULTS\nNurses demonstrated shorter sleep hours, lower sleep efficiency, and longer sleep latency before night shifts compared to other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70.\n\n\nCONCLUSIONS\nSleep parameters and fatigue level contributed to the differences in decline in alertness across shifts.\n\n\nIMPLICATION FOR NURSING MANAGEMENT\nFindings inform nurse managers, administrators, and intervention development to reduce fatigue, improve sleep quantity and quality, and increase alertness among rotating-shift nurses. Management, institutional, and individual factors should be considered when developing interventions.