Conectar
This project team aims to (1) evaluate the effectiveness of the Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE) program in improving the work environment, workplace mental health, and nurse outcomes, and (2) examine underlying factors influencing job satisfaction and intent to leave among staff nurses.
Quasi-experimental designs with one-group pre–post program design using online surveys.
Pre-program data were collected in June 2022 (n = 706), followed by the implementation of multifaceted, evidence-based interventions delivered by the WE CARE team, such as wellness rounding and resilience education. Post-program data were collected in November 2024 (n = 417). Mixed-effects regression models were utilised for analysis.
The WE CARE program was associated with statistically significant improvements in the overall work environment, workplace mental health (excluding resilience), and nurse outcomes, including job satisfaction and intent to leave. Job satisfaction positively correlated with a supportive work environment, recognition, and trust in supervisors, and negatively correlated with burnout, compassion fatigue, and distress. Higher levels of burnout and distress significantly increased the likelihood of nurses intending to leave their jobs, while greater trust in leadership and perceived organisational support were protective factors against leaving the job.
The project supports the effectiveness of evidence-based workforce engagement interventions in real-world healthcare settings to enhance the work environment, workplace mental health, and nurse outcomes. Interventions targeting emotional well-being, recognition, burnout reduction, and leadership trust may improve job satisfaction and reduce nurses' turnover intentions.
The program directly resulted in nurse leaders recognising the value of the WE CARE initiative and sustaining the team beyond the funding period. This project addresses a significant gap in the nurse well-being literature by demonstrating the effectiveness of a nurse-led, multifaceted wellness program designed specifically for nurses.
No patient or public contribution.
To investigate associations between shift work patterns and sleep disturbance, and to assess if the association is modified by demographic factors, socioeconomic factors, anthropometric and lifestyle factors, health conditions or sleep traits.
Analysis of cross-sectional data obtained from the UK Biobank baseline assessment.
UK Biobank, a large-scale prospective cohort study which recruited half a million participants aged 40–69 years between 2006 and 2010 from across the UK.
A total of 285 175 employed or self-employed participants at baseline (2006–2010), including 148 296 (52.0%) females and 136 879 (48.0%) males. The sample comprised 94.0% White, 0.7% Mixed race, 0.36% East Asian, 2.0% South Asian, 1.8% Black and 0.89% from other ethnic backgrounds.
Sleep disturbance was defined as the presence of both insomnia and excessive sleepiness symptoms.
A total of 42 181 (14.8%) participants had sleep disturbance defined based on insomnia and excessive sleepiness. 236 200 (82.8%) were non-shift workers, while 48 975 (17.2%) were shift workers, which included 24 062 (49.1%) working day shifts only, 17 940 (36.6%) working night shifts sometimes or usually, and 6973 (14.2%) working night shifts always. Compared with non-shift workers, all shift workers had higher multivariable-adjusted odds of sleep disturbance: (non-night shifts: OR in model 3 (OR) 1.21 (95% CI 1.16 to 1.27); sometimes/usually night shifts: OR 1.37 (95% CI 1.30 to 1.44) and always night shifts: OR 1.50 (95% CI 1.38 to 1.63)). The association between shift work pattern and sleep disturbance was modified by age (pinteractioninteraction=0.0005) and smoking status (pinteraction=0.04).
Shift work is associated with a higher odds of sleep disturbance compared with non-shift work in all participants, with greatest odds observed among those always working night shifts. The association was stronger among individuals who were younger than 55 years old, from an ethnic minority background and never smokers. Future large-scale longitudinal studies are needed to further investigate these associations.
by Ian C. Murphy, Kelly Bryan, Muriel Burk, Rong Jiang, Francesca Cunningham, Sarah Providence, Elizabeth Rightnour, Sarah Zavala, Kathleen Morneau, Trisha Exline, Stacey Rice, Travis Schmitt, Kelly Drumright, Jennifer Lee, BreAnna Davids, Tram Guilbeault, Brooke Klenosky, Ann-Marie Sutherland, Abbie Rosen, Lauren Ratliff, Kenneth Bukowski, Margaret A. Pisani, Andrew Franck, Mark Wong, Preston Witcher, Kathleen M. Akgün
OBJECTIVESEarly data suggested higher sedative requirements for ventilated COVID+ patients, deviating from established guidelines. We assessed the relationship between sedative use and outcomes in mechanically ventilated Veterans during the COVID-19 pandemic.
DesignRetrospective Medication Use Evaluation
SettingNational Sample of 13 Distinct VA Medical Center Intensive Care Units
PatientsCritically ill Veteran patients requiring mechanically ventilation for ≥2 days
InterventionsNone.
Measurements and main resultsThe proportion of patients receiving fentanyl, midazolam and propofol was higher during COVID years. Compared with pre-COVID, median fentanyl dose was higher during Years 1 and 2 (1575mcg [(IQR) 1000–1650] vs. 1900 [1250–3000] vs. 1910 [1150–3500]). Adjuvant antipsychotics use was relatively low but tended to increase over time (pre = 10.5% vs. Year 1 = 12.3% vs. Year 2 = 14.1%). Most patients started on antipsychotics in the ICU were continued on the drug after extubation. Mortality was higher during COVID years (pre = 26.9% vs. 1 = 36.8% and 2 = 35.9%). In stratified analyses by COVID status years 1–2 (n = 79, 27%), a higher proportion of COVID+ patients received fentanyl (96% vs. 84%) and propofol (90% vs. 77%) and at higher doses (fentanyl = 1650mcg vs. 2688mcg median cumulative dose; propofol maximum infusion rate = 30 mc/kg/min (20–50) vs. 40 (25–50)). Sedative doses were similar to pre-COVID among non-COVID patients. Anti-psychotics were more frequently continued post extubation among COVID+ (34.6% vs. non-COVID+=14.9%). COVID+ patients were also less likely to have awakening and breathing trials at 48 hours after intubation (18% vs. 46%).
ConclusionsSedative use and dosing increased during the first two years of COVID compared to pre-COVID, especially for COVID+ patients. The sustained elevated levels of fentanyl use in Year 2 suggests possible ‘therapeutic creep’ away from guideline-concordant practices for COVID+ patients. Antipsychotic prescription during intubation and following extubation was also more common among COVID + . These findings could inform development and implementation of safer sedation practices across VA ICUs during respiratory pandemics.
FreshRSS