Disciplines

Nursing

Abstract (300 words maximum)

Abstract

The purpose of this evidence-based practice project is to evaluate the effects of ensuring an uninterrupted 30-minute break during each shift on the quality of care delivered by inpatient nurses working 12-hour long shifts. An uninterrupted break constitutes a complete absence of patient care including answering work-related calls and watching patient monitors. Nearly half of nurses report that they are not fully free of patient-care responsibilities when taking breaks at work [6] and continually miss meal breaks, often getting only a few minutes of break time each shift [1, 3, 5, 6]. Nurses physically exert themselves every shift by turning, lifting, and ambulating patients as well as leaning over the bedside to administer medications and perform nursing cares. Emotional stamina is further needed daily to communicate with vulnerable and sick patients alongside their worried families during health crises. This exertion combined with heavy workloads, long hours, short breaks, and low staffing are all factors faced by nurses that increase levels of fatigue and create a challenging environment to provide safe patient care. Fatigue has been shown to be negatively correlated with break time taken by nurses [6] and negatively impacts physical and mental well-being. Opposingly, nurse performance is positively correlated with the amount of break time taken [3]. In this project, uninterrupted 30-minute breaks will be guaranteed for nurses during their shift report upon arrival to work. Each nurse will take report for one additional patient whom they will only provide care for during another nurse’s break. This ensures that a full report is given rather than a traditionally brief report given when a nurse begins their break. Quality of care will be measured by occurrences of medication/medical errors, patient safety incidences (falls, catheter-associated urinary tract infections, central line-associated infections), and self-reports of staff physical/mental well-being. This data will be collected over 6 months.

References

1) Bartzak, P. J. (2019). Caring for a Colleague’s Patient Assignment While They’re on a Lunch Break. Med-Surg Matters, 28(1), 3–9. [1]

2) Georgia Law on Meal and Rest Breaks. (n.d.). Www.nolo.com. https://www.nolo.com/legal-encyclopedia/georgia-law-meal-rest-breaks.html

3) Landis, T. T., Wilson, M., Bigand, T., & Cason, M. (2021). Registered Nurses’ Experiences Taking Breaks on Night Shift: A Qualitative Analysis. Workplace Health & Safety, 69(6), 252–256. https://doi.org/10.1177/2165079920983018

4) Li, H, Shao, Y, Xing, Z, et al. Napping on night-shifts among nursing staff: A mixed-methods systematic review. J Adv Nurs. 2019; 75: 291– 312. https://doi.org/10.1111/jan.13859

5) Min, A., Yoon, Y. S., Hong, H. C., & Kim, Y. M. (2019). Association between nurses’ breaks, missed nursing care, and patient safety in Korean hospitals. Journal of Nursing Management. https://doi.org/10.1111/jonm.12831

6) Nejati, A., Shepley, M., & Rodiek, S. (2016). A Review of Design and Policy Interventions to Promote Nurses’ Restorative Breaks in Health Care Workplaces. Workplace Health & Safety, 64(2), 70–77. https://doi.org/10.1177/2165079915612097

Academic department under which the project should be listed

Wellstar School of Nursing

Primary Investigator (PI) Name

Christie Emerson

Included in

Nursing Commons

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The Effect of Uninterrupted Breaks on Quality of Care Delivered by Bedside Nurses

Abstract

The purpose of this evidence-based practice project is to evaluate the effects of ensuring an uninterrupted 30-minute break during each shift on the quality of care delivered by inpatient nurses working 12-hour long shifts. An uninterrupted break constitutes a complete absence of patient care including answering work-related calls and watching patient monitors. Nearly half of nurses report that they are not fully free of patient-care responsibilities when taking breaks at work [6] and continually miss meal breaks, often getting only a few minutes of break time each shift [1, 3, 5, 6]. Nurses physically exert themselves every shift by turning, lifting, and ambulating patients as well as leaning over the bedside to administer medications and perform nursing cares. Emotional stamina is further needed daily to communicate with vulnerable and sick patients alongside their worried families during health crises. This exertion combined with heavy workloads, long hours, short breaks, and low staffing are all factors faced by nurses that increase levels of fatigue and create a challenging environment to provide safe patient care. Fatigue has been shown to be negatively correlated with break time taken by nurses [6] and negatively impacts physical and mental well-being. Opposingly, nurse performance is positively correlated with the amount of break time taken [3]. In this project, uninterrupted 30-minute breaks will be guaranteed for nurses during their shift report upon arrival to work. Each nurse will take report for one additional patient whom they will only provide care for during another nurse’s break. This ensures that a full report is given rather than a traditionally brief report given when a nurse begins their break. Quality of care will be measured by occurrences of medication/medical errors, patient safety incidences (falls, catheter-associated urinary tract infections, central line-associated infections), and self-reports of staff physical/mental well-being. This data will be collected over 6 months.

References

1) Bartzak, P. J. (2019). Caring for a Colleague’s Patient Assignment While They’re on a Lunch Break. Med-Surg Matters, 28(1), 3–9. [1]

2) Georgia Law on Meal and Rest Breaks. (n.d.). Www.nolo.com. https://www.nolo.com/legal-encyclopedia/georgia-law-meal-rest-breaks.html

3) Landis, T. T., Wilson, M., Bigand, T., & Cason, M. (2021). Registered Nurses’ Experiences Taking Breaks on Night Shift: A Qualitative Analysis. Workplace Health & Safety, 69(6), 252–256. https://doi.org/10.1177/2165079920983018

4) Li, H, Shao, Y, Xing, Z, et al. Napping on night-shifts among nursing staff: A mixed-methods systematic review. J Adv Nurs. 2019; 75: 291– 312. https://doi.org/10.1111/jan.13859

5) Min, A., Yoon, Y. S., Hong, H. C., & Kim, Y. M. (2019). Association between nurses’ breaks, missed nursing care, and patient safety in Korean hospitals. Journal of Nursing Management. https://doi.org/10.1111/jonm.12831

6) Nejati, A., Shepley, M., & Rodiek, S. (2016). A Review of Design and Policy Interventions to Promote Nurses’ Restorative Breaks in Health Care Workplaces. Workplace Health & Safety, 64(2), 70–77. https://doi.org/10.1177/2165079915612097