Using the article “Napping of the Nightshift: A Two-Hospital Implementation Proj

Question

Using the article “Napping of the Nightshift: A Two-Hospital Implementation Project” by Jeanne Geiger-Brown, Knar Sagherian, Shijun Zhu, Margaret Wieroniey, Lori Blair, Joan Warren, Pamela Hinds and Rose Szeles. https://journals.lww.com/ajnonline/Fulltext/2016/05000/CE___Original_Research___Napping_on_the_Night.27.aspx

(*****There is no data, the article website is above- the questions that need to be answered are below also)

State the results of the research, describing how the researchers determined whether or not the results are statistically significant.

Describe the differences in the results between the groups in the study and support your description with examples from the study.

Explain the limitations presented by the study population and sample size used. Support your explanation with examples from the study.

Discuss the advantages and disadvantages of the type of statistical analysis used. Support your discussion with examples from the study.

Identify the limitations of the study design used and explain why those limitations exist.

Explanation / Answer

1.State the results of the research, describing how the researchers determined whether or not the results are statistically significant.

-The pilot project was offered to 6 nursing units but successful implementation was done only on 1 unit. Barriers primarily occurred at the point of seeking the unit nurse managers’ approval for other 4 units. The project was approved for remaining 1 unit but it was not succesfully implemented as nurses were pulled to work during their nap time due to shortage of resources. So, data was collected from only one unit where implementation was successful. A total of 153 nap experience forms were collected and analyzed. The average nap duration was 31 minutes (SD, 5.4 minutes). Most participants reported some sleepiness immediately before the nap (mean KSS score, 6.1; SD, 1.8), which is to be expected on the night shift. For 44.2% of naps, nurses reported KSS scores between 7 and 9. For more than half of naps, nurses reported actual sleep, with 43% reporting that they slept lightly and 14% reporting that they slept deeply. Sleep inertia was relatively rare, with 1.3% of naps ending in the nurse feeling “very groggy or sluggish” and 20.3% of naps ending in the nurse feeling “a little groggy or sluggish.” Nurses reported feeling “alert and refreshed” at the end of 56.2% of naps. Regarding the helpfulness of napping, the average score was 7.3 out of 10 (SD, 2.2). The researchers determined that results are statistically significant by comparing them with other studies. Their results were consistent with results from multiple experimental napping studies reviewed by Ruggiero and Redeker regarding drowsy driving and accidents associated with it. Their study was also consistent with those of Rogers and colleagues, who found that nurses often failed to take breaks, despite shift durations of 12 or more hours. They also found their barriers for implementation similar to  Edwards and colleagues, who found that nurse managers’ experience with and attitudes toward napping were a crucial barrier.

2. Describe the differences in the results between the groups in the study and support your description with examples from the study.

-There were several differences found in the results between groups. Few nurses were feeling "very groggy or sluggish" after napping. Some were feeling "a little groggy or sluggish" while most of them were feeling "alert and refreshed". These differences were there because each nap was assessed as an independent event and did not collect data on the identity of the nurse. The other factors were not assesed including within-subject results. Also all the nurses were not at same level of sleepiness before taking nap and the sleep pattern was different for some of them. Some of them experienced light sleep, some deep sleep while remaining were in awake stage. So, the final results were impacted as all the nurses sleep behaviour were different.

3. Explain the limitations presented by the study population and sample size used. Support your explanation with examples from the study.

-The sample size used was only from one unit of the hospital which was not significant enough to implement the napping strategy on all units of the hospital. The study population was taken for the units where nurses manager allowed for the pilot programme implementation, so the study went smoothly for the given population. But it was not able to address the barriers in other units of the hospital. Also different units have different framework to serve patients. Some are more critical units where nurses' presence is required all the time to avoid any emergency situation. So, the results do not have any wider scope. A larger sample is needed in order to identify and better understand all of the barriers to implementation, as well as the best methods for overcoming these. Also within the unit where implementation was succesful, there were differences in the results since the nap event for each nurse was considered as independent event irrespective of the subjectivity of a person. In order to present coherent results, data regarding identity and traits of each nurse was supposed to be included in the study.

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