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Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses

교대근무 간호사의 혈액과 체액 노출 경험과 수면장애, 피로, 직무스트레스와 상관성

  • Received : 2018.07.15
  • Accepted : 2018.08.09
  • Published : 2018.08.31

Abstract

Purpose: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. Methods: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. Results: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance ($ISI{\geq}15$), fatigue (FSS $score{\geq}4$), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS $score{\geq}4$). Conclusion: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Keywords

References

  1. Korean Society for Healthcare-associated Infection Control and Prevention. Infection control and prevention in healthcare facilities. 5th ed. Seoul: Hanmiuihag; 2017. p. 897-910.
  2. Kim OS, Choi JS, Jeong JS, Park ES, Yoon SW, Jung SY, et al. Survey of under-reporting rate and related factors after blood and body fluid exposure among hospital employees. Journal of Korean Academy of Adult Nursing. 2010;22(5):466-476.
  3. Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick injuries in the United States: Epidemiologic, economic, and quality of life issues. Workplace Health & Safety. 2005; 53(3):117-133.
  4. Perry J, Parker G, Jagger J. EPINet Report: 2007 Percutaneous Injury Rates. Final report. Virginia: International Healthcare Worker Safety Center; 2009 Aug.
  5. Jeong JS. Infection status and risk of healthcare worker: Targeting needle stick injuries. Paper presented at: Conference of the Korean Society of Occupational and Environment; 2013; Seoul.
  6. Jeong JS. Surveillance system on neelde stick injuries. Final report. Incheon: Korea Occupational Safety and Health Agency; 2012.
  7. Kim HC, Kim YK, Lee YC, Shin JY, Lee JN, Leem JH, et al. The relationship between job stress and needlestick injury among nurses at a university hospital. Korean Journal of Occupational and Environmental Medicine. 2005;17(3):216-224.
  8. Choi JS, Kim KS. Application and evaluation of a web-based education program on blood-borne infection control for nurses. Journal of Korean Academy of Nursing. 2009;39(2):298-309. https://doi.org/10.4040/jkan.2009.39.2.298
  9. Mangione CM, Gerberding JL, Cummings SR. Occupational exposure to HIV: Frequency and rates of underreporting of percutaneous and mucocutaneous exposures by medical housestaff. American Journal of Medicine. 1991;90(1):85-90. https://doi.org/10.1016/0002-9343(91)90510-5
  10. Kim OS. Development and effectiveness of a prevention model of bloodborne disease exposure among health care workers [dissertation]. Seoul: Yonsei University; 2004.
  11. Miranda-Pettersen K, Morais-de-Jesus M, Daltro-Oliveira R, Dantas Duarte Dias A, Teles C, Schinoni MI, et al. The fatigue impact scale for daily use in patients with hepatitis B virus and hepatitis C virus chronic infections. Annals of Hepatology. 2015;14(3):310-316.
  12. Harrington JM. Health effects of shift work and extended hours of work. Occupational and Environmental Medicine. 2001;58(1):68-72. https://doi.org/10.1136/oem.58.1.68
  13. Stimpfel AW, Brewer CS, Kovner CT. Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study. International Journal of Nursing Studies. 2015;52(11):1686-1693. https://doi.org/10.1016/j.ijnurstu.2015.06.011
  14. Shin EJ, Park HR. Risk factors of blood and body fluid exposure in clinical nurses. Journal of Korean Academy of Fundamentals of Nursing. 2006;13(3):368-375.
  15. Choi JS. A study on KAP of medical peronnel against exposure to the patient's blood and fluids in special department of a general hospital: Focused on intensive care unit, emergency unit, haemodialysis unit, operating unit, microbiological laboratory [master's thesis]. Seoul: Seoul National University; 1998.
  16. Yoon IY, Ha M, Park JS, Song BG. Comparison of sleep patterns and autonomic nervous system activity among three shifts in shiftworkers. Sleep Medicine and Psychophysiology. 2000;7(2):96-101.
  17. Baek JH, Choi-Kwon S. Sleep patterns, alertness and fatigue of shift nurses according to circadian types. Journal of Korean Biological Nusing Science. 2017;19(3):198-205. https://doi.org/10.7586/jkbns.2017.19.3.198
  18. Chaiard J, Deeluea J, Suksatit B, Songkham W, Inta N. Short sleep duration among Thai nurses: Influences on fatigue, daytime sleepiness, and occupational errors. Journal of Occupational Health. 2018. https://doi.org/10.1539/joh.2017-0258-OA
  19. Lo WY, Chiou ST, Huang N, Chien LY. Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey. International Journal of Nursing Studies. 2016;64:130-136. https://doi.org/10.1016/j.ijnurstu.2016.10.007
  20. Suzuki K, Ohida T, Kaneita Y, Yokoyama E, Miyake T, Harano S, et al. Mental health status, shift work, and occupational accidents among hospital nurses in Japan. Journal of Occupational Health. 2004;46(6):448-454. https://doi.org/10.1539/joh.46.448
  21. Uehli K, Mehta AJ, Miedinger D, Hug K, Schindler C, Holsboer-Trachsler E, et al. Sleep problems and work injuries: A systematic review and meta-analysis. Sleep Medicine Reviews. 2014;18(1):61-73. https://doi.org/10.1016/j.smrv.2013.01.004
  22. Costa G. The impact of shift and night work on health. Applied Ergonomics. 1996;27(1):9-16. https://doi.org/10.1016/0003-6870(95)00047-x
  23. Gershon RR, Karkashian CD, Grosch JW, Murphy LR, Escamilla-Cejudo A, Flanagan PA. Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control. 2000;28(3):211-221. https://doi.org/10.1067/mic.2000.105288
  24. Cho E, Lee H, Choi M, Park SH, Yoo IY, Aiken LH. Factors associated with needlestick and sharp injuries among hospital nurses: A cross-sectional questionnaire survey. International Journal of Nursing Studies. 2013;50(8):1025-1032. https://doi.org/10.1016/j.ijnurstu.2012.07.009
  25. Wicker S, Stirn AV, Rabenau HF, von Gierke L, Wutzler S, Stephan C. Needlestick injuries: Causes, preventability and psychological impact. Infection. 2014;42(3):549-552. https://doi.org/10.1007/s15010-014-0598-0
  26. Smith DR, Mihashi M, Adachi Y, Shouyama Y, Mouri F, Ishibashi N, et al. Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses. American Journal of Infection Control. 2009;37(7):545-550. https://doi.org/10.1016/j.ajic.2008.11.004
  27. Choi JS. Application and evaluation of a web-based education program on blood-borne infection control for nurses [dissertation]. Seoul: Seoul National University; 2007. p. 101.
  28. Yi YH, Choi SJ. Association of sleep characteristics with medication errors for shift work nurses in intensive care units. Journal of Korean Fundmental Nurisng. 2014;21(4):403-412. https://doi.org/10.7739/jkafn.2014.21.4.403
  29. Morin CM. Psychological assessment and management. New York: Guilford Press; 1993.
  30. Bastien CH. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine. 2001.2(4):297-307. https://doi.org/10.1016/s1389-9457(00)00065-4
  31. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of Neurology. 1989;46(10):1121-1123. https://doi.org/10.1037/t25491-000
  32. Chung KI, Song CH. Clinical usefulness of fatigue severity scale for patients with fatigue, and anxiety or depression. Korean Journal of Psychosomatic Medicine. 2001;9(2):164-173.
  33. Chang SJ. Reevaluation of the KOSS based on the items and structure. Korean Society of Occupational Stress. 2007;1(1):83-96.
  34. Chang SJ, Koh SB, Kang DM, Kim SA, Kang MG, Lee CG, et al. Developing an occupational stress scale for korean employees. Korean Journal of Occupational and Environmental Medicine. 2005;17(4):297-317.
  35. Kwon M, Kim SL. The Job stress and presenteeism of occupational health nurses in workplace in Korea. Korean Journal of Occupational Health Nursing. 2010;19(2):159-169.
  36. Yoo JY, Lee JH. Complex impact of patient safety and medical quality on hospital management activities due to healthcare accreditation adoption. Journal of Digital Convergence. 2015;13(7):283-292. https://doi.org/10.14400/jdc.2015.13.7.283
  37. Yassi A, Moore D, Fitzgerald JM, Bigelow P, Hon CY, Bryce E. Research gaps in protecting healthcare workers from SARS and other respiratory pathogens: An interdisciplinary, multi-stakeholder, evidence-based approach. Journal of Occupational and Environmental Medicine. 2005;47(1):41-50. https://doi.org/10.1097/01.jom.0000150207.18085.41
  38. Jeong JS. Post-exposure treatment and seroconversion to blood-borne viruses after needlestick injuries among healthcare personnel. Journal of Korean Biological Nusing Science. 2014;16(1):26-32. https://doi.org/10.7586/jkbns.2014.16.1.26
  39. Tomkins SE, Elford J, .Nichols T, Aston J, Cliffe SJ, Roy K, et al. Occupational transmission of hepatitis C in healthcare workers and factors associated with seroconversion: UK surveillance data. Journal of Viral Hepatitis. 2012;19(3):199-204. https://doi.org/10.1111/j.1365-2893.2011.01543.x
  40. Cho YW, Shin WC, Yun CH, Hong SB, Kim J, Earley CJ. Epidemiology of insomnia in Korean adults: Prevalence and associated factors. Journal of Clinical Neurology. 2009;5(1):20-23. http://dx.doi.org/10.3988/jcn.2009.5.1.20
  41. Schmid K, Schwager C, Drexler H. Needlestick injuries and other occupational exposures to body fluids amongst employees and medical students of a German university: Incidence and follow-up. Journal of Hospital Infection. 2007;65(2):124-130. https://doi.org/10.1016/j.jhin.2006.10.002
  42. Surani S, Hesselbacher S, Guntupalli B. Sleep quality and vigilance differ among inpatient nurses based on the unit setting and shift worked. Journal of Patient Safety. 2015;11(4):215-220. https://doi.org/10.1097/pts.0000000000000089
  43. Fisman DN, Harris AD, Rubin M, Sorock GS, Mittleman MA. Fatigue increases the risk of injury from sharp devices in medical trainees: results from a casecrossover study. Infection Control & Hospital Epidemiology. 2007;28(1):10-17. https://doi.org/10.1086/510569
  44. Korean Centers for Disease Control and Prevention. Infectious disease portal [Internet]. Osong: Korean Centers for Disease Control and Prevention; 2018 [cited 2018 Jul 5]. Available from: http://www.cdc.go.kr/npt/biz/npp/nppMain.do.
  45. Chen J1, Davis KG, Daraiseh NM, Pan W, Davis LS. Fatigue and recovery in 12-hour dayshift hospital nurses. Journal of Nurisng Management. 2014;22(5):593-603. https://doi.org/10.1111/jonm.12062

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