Using Cognitive-Behavioral Change and Mobile Technology to Improve RN Sleep and Fatigue

项目摘要 美国注册护士(RN)是医疗保健和社会援助部门中规模最大的员工之一， 由于睡眠不佳和疲劳，受伤和出错的风险很高。轮班工作(即夜间、夜间、轮换 轮班)会导致RN得不到充足、安宁的睡眠。工作强度，包括繁重的体力和 照顾危重病人的情绪工作量会增加工作压力，导致溢出效应 在家中，当RN遇到摔倒和保持睡眠困难的时候。为了解决工作和家庭睡眠障碍- ERS，该项目提出了RN-SLEEP、技能培养移动应用的开发和中试测试 旨在改善睡眠。RN-睡眠将为RN提供一个方便、灵活的空间来学习证据- 基于轮班工作的特定策略和认知行为方法(例如，目标设定、放松训练)以 提高睡眠质量。使用NIOSH的研究2实践(R2P)方法，研究团队将与PAR- 来自RN联盟的参与者(N=18-24)，以完善RN-睡眠内容，整合当前的睡眠文献(包括- ING国家职业安全与健康研究所[NIOSH]材料)，基于认知-行为 训练。RN-睡眠将使用两组前测-后测研究设计进行先导测试，比较睡眠时间和睡眠时间 来衡量RN-睡眠参与者用户(n=35)的指标(持续时间、质量)，参与者来自教育背景 对照组(n=35)。关于行为改变(信念和自我效能)和其他睡眠结果的数据趋势 将探索措施(时间、规律性、效率、白天嗜睡)。RN-睡眠目标与 健康人2030，NIOSH的战略目标是促进安全和健康的工作设计和福祉， 通过两个NIOSH医疗和社会援助部门/健康工作设计跨部门 (HCSA/HWD)中期目标。卫生与公众服务部的目标7.2a是进行针对疲劳的干预研究 (睡眠后遗症不佳)是由于医疗保健行业的工作设计(倒班工作)不佳。HCSA/HWD目标 7.12A将旨在影响安全和健康的工作和非工作贡献者的干预措施列为优先事项。这 RN-睡眠干预旨在通过培养帮助RN克服障碍的技能来改善睡眠 在工作和家里睡觉，从而改善健康和安全。立即产生的结果包括一款移动应用程序，de- 与RNS合作签署和测试，以改善睡眠。研究结果将透过我们的 联盟合作者、护理会议和期刊出版物，以及我们大学的NIOSH赞助的EDU- 阳离子与研究中心社交媒体渠道。中间结果包括增强RN睡眠 通过在护理学校和传统的健康和安全培训项目中很少提供的培训。改进- ING睡眠可以减少疲劳，并可能减少职业伤害和失误。RN睡眠是可适应的， 未来的版本可以被修改以满足其他HCSA工作人员(即护理助手)的需求 其他行业(如石油和天然气)的工人安排非标准工作时间。最终结果是- 包括将RN睡眠整合到更广泛的医院组织干预中，以减轻疲劳风险。

Project Summary The U.S. registered nurse (RN) workforce is one of the largest in the Healthcare and Social Assistance Sector, and at high risk for injuries and errors due to poor sleep and fatigue. Shift work (i.e., nights, evenings, rotating shifts) can contribute to RNs not obtaining adequate, restful sleep. Work intensity, including heavy physical and emotional workloads of caring for critically ill patients, can contribute to job stress, resulting in spill-over effects at home when RNs experience difficulties falling and staying asleep. To address work and home sleep barri- ers, this project proposes the development and pilot testing of RN-SLEEP, skill-building mobile application designed to improve sleep. RN-SLEEP will provide a convenient, flexible space for RNs to learn evidence- based shift work specific strategies, and cognitive-behavioral methods, (e.g., goalsetting, relaxation training) to enhance sleep. Using NIOSH’s Research 2 Practice (R2P) approach, the study team will collaborate with par- ticipants (N=18-24) from an RN union to refine RN-SLEEP content, integrating current sleep literature (includ- ing National Institute for Occupational Safety and Health [NIOSH] material) with cognitive-behavioral based training. RN-SLEEP will be pilot-tested using a two-group pretest-posttest study design, comparing sleep out- come measures (duration, quality) of RN-SLEEP participant users’ (n=35) with participants from an education control group (n=35). Data trends on behavior change (beliefs and self-efficacy) and other sleep outcome measures (timing, regularity, efficiency, daytime sleepiness) will be explored. RN-SLEEP goals align with Healthy People 2030, NIOSH strategic goal to promote safe and healthy work design and well-being, through two NIOSH Healthcare and Social Assistance Sector/Healthy Work Design Cross-Sector (HCSA/HWD) intermediate goals. HWD goal 7.2A is to conduct intervention research addressing fatigue (poor sleep sequala) due to suboptimal work designs (shift work) in the healthcare industry. HCSA/HWD goal 7.12A prioritizes interventions designed to impact work and non-work contributors to safety and health. This RN-SLEEP intervention aims to improve sleep through building skills that help RNs overcome obstacles to sleep from work and home, thus improving health and safety. Immediate outputs include a mobile app, de- signed and tested in collaboration with RNs, to improve sleep. Study results will be disseminated through our union collaborators, nursing conferences and journal publications, and our University’s NIOSH sponsored Edu- cation and Research Center social media outlets. Intermediate outcomes include enhancing RN sleep through training rarely available in nursing school and traditional health and safety training programs. Improv- ing sleep can reduce fatigue and may decrease occupational injuries and errors. RN-SLEEP is adaptable, where future versions could be modified to meet the needs of other HCSA workers (i.e., nursing aides) and workers in other industries (e.g., oil and gas) scheduled to work non-standard work hours. End outcomes in- clude integrating RN-SLEEP into a broader hospital organization intervention to mitigate fatigue risks.