Effect on Staff Health and Attendance-Free-Samples for Students

Question: Disucss about the Impact of long working hours upon the health of nurses within an acute healthcare setup. Answer: Introduction Work life balance is one of the most talked about concepts within the current day workplace scenario as stress in the place of work has been seen to affect the physical and mental health of individuals considerably. The current study focuses upon the impact of long working hours upon the health of nurses within an acute healthcare setup. The current research project conducts a pilot study of the various factors within a workplace setting that can have a profound effect on staff health and attendance. Here, sudden increases in the absence of the nursing staffs have been noted which could be attributed to long working hours. The sudden changes in the shift duration of 7.5 hours to 12 hours have drastically increased the sickness rate among the staffs. The longer duration of work, lack of sleep and rest can be some of the instigating factors in deteriorating the health of employed nurses within a health care set up. Reports and evidence have also directly correlated increased rate of accidents to overtired healthcare staffs (Leow Chan, 2017). The absence of an adequate number of staffs can also affect the care quality and the services offered within a clinical, set up. In the current assignment, we have tried to focus upon the key pieces of evidence which reflect upon the chosen scenario. The methodology of the research had also been designed in accordance with the requirements of data analysis and interpretation. The goal of the assignment is to highlight the contributing factors towards increasing work pressure which has a negative impact on the mental, emotional and physical well being of a staff. Apart from longer shift durations, there are other contributing factors which also affect the well being of the staff such as workpl ace infrastructural support which is a necessary component and should be planned carefully (Penkunas et al., 2016). Research question, aim and hypothesis Aim: To investigate the claim about the effect of significant long working hours over the health of nursing professionals Research question What is the impact of long working hours upon the health of nursing professionals? Hypothesis H0= Long working hours are not responsible for deterioration of health of the nursing staff H1= Long working hours are responsible for health deterioration in the nursing staff Key pieces of evidence relevant to chosen scenario There has been evidence in the past where an overtired nurse has forgotten to brief regarding the most important details pertaining to the health of a patient in emergency trauma care to the concerned staff during shift change. As commented by Lin, Liao, Chen Fan (2014), such overtired staff has also been represented by a massive number of employee or staff turnover. Therefore, a detailed study had been conducted over here exploring the different areas of work division and maintenance of work-life balance within an acute care setup. As commented by Zboril-Benson (2016), long durations combined with rotational shifts may actually take the health of the nursing staff adding to fatigue which may impact the quality of healthcare services. However as argued by Kuo, Lin Li (2014), despite regulations for cumulative shift length for residential physicians and workers in other industries such policy and framework are lacking the nurses. The long working hours have been seen to result in gr eater amount of burnout within the nursing professionals (Steinmetz, de Vries Tijdens, 2014). Burnout could be characterised by emotional exhaustion, lack of attachment to patients, which could greatly impair the care services (Jamieson, Kirk, Wright Andrew, 2015). In this respect, additional data collection and research analysis mentioned that nurses working overtime would often not communicate well with the patients; neither were some of the crucial things such as pain well managed or controlled (Volpe et al., 2014). Some of the regulatory bodies such as Accreditation Council for Graduate Medical Education (ACGME) have restricted the working or shift hours of the physicians. In this respect, three separate aspects could be discussed in detail which consecutively impacts the health of the nursing professionals such as lack of sleep, extended work hours and rotational shifts. The lack of sleep has been one of the most common factors affecting the health of the nursing professionals. As commented by Griffiths et al. (2014), less sleep can result in a number of problems such as mood disorders, deficit of attention at place of work. These factors can significantly contribute to the deterioration of overall health and well being of a person. The ex tended work hours and consecutive shifts have often been related to digestive disorders, hypertension within the nursing staffs. Reports and evidence have shown that a clear link exists between sleep deprivation and obesity. As commented by Allen, Holland Reynolds (2015), short sleep duration has been seen to develop the tendency of glucose tolerance and promote incidents of diabetes in women. In this respect, insufficient sleep has been seen to result in occurrences of cardiovascular diseases among the healthcare professionals. Additionally, less sleep has been seen to cause hormonal misbalance by disturbing the levels of leptin, cortisol and thyrotropin (Gross, 2017). Some of these hormones have been seen to control the menstrual cycles in women. Thus, disruption in the normal hormonal levels can result in mood disorders and related health problems. The lack of sleep has also been correlated with less immunity in the healthcare staff (Sanso et al., 2015). However, workings for more than 40 hours per week affect the health of the nursing professional to a great extent (Jennings, Clifford, Fox, OConnell Gardner, 2015). The extended shifts have been associated with increased musculoskeletal injuries, cardiovascular conditions and development of hypertension. The increased neck and muscular discomfort due to working long hours have also been seen to affect the staff attendance (Sacco, Ciurzynski, Harvey Ingersoll, 2015). In this respect, the nursing professionals have often been seen to take longer holidays or miss duties owing to stiffness or pain in the body. As asserted by Arnold, Teijlingen, Ryan Holloway (2015), a satisfied staff have been seen to reduce incidents of massive turnover at workplace. Hierarchy of evidence Figure 1: Hierarchy of evidence (Source: Allen, Holland Reynolds, 2015) The literature sources used above are cross-sectional studies conducted under randomised control trials and helps in comparing between control and intervention groups. The hierarchy of evidence can be further divided into seven different levels or cycles. The level 1 emphasizes upon systematic review of randomised controlled trials. In the second level, the search strategy is further narrowed down where singly randomised trials are taken into consideration. From level 3 to 4 correlational and observational studies are conducted where different case studies are analysed further to find out the common patterns. This further helps in addressing the identified gaps or loopholes in the current situation. The level 5 to 6 focuses on data collection methods such as quantitative/qualitative research design. For the present study, we have taken into consideration face-to-face interview methods along with survey for collection of data regarding the problem situation of increased rate of health -related absence from work. The responses will be further compared with expert opinions and management authorities in charge of the nursing services delivery. Research pilot design Background analysis There have been incidents where the nurses have failed to keep a record of the exact medication doses to be delivered to the patients. This had resulted in cases of casualties within an acute care set up and often endangers reputation of the hospital. As per reports and evidence, several states such as California and Maryland have restricted longer work hours for the nurses (Jamieson, Kirk, Wright Andrew, 2013). However, no restrictions are imposed upon the voluntary overtime by the staffs of the hospital. Further research has highlighted two major contributing factors for wilful overtime by the nurses. These conditions could be summarised as shortage of nurses leading to more pressure on individual staffs along with weaker economy. However, such restriction of timings is yet to develop for the nurses. Reports and evidence have suggested that the normal accepted length of duty hours was put at 12 hours for most hospital set up on a larger scale. As argued by Lesuffleur, Chastang, Sandret Niedhammer (2014), most of the nurses have been found to be satisfied with long duty hours and would never complain. The reason was thought to be low salary being paid to the nurses; where a hike in the work hours would also mean a hike in the last drawn salary. Working on consecutive extended shifts can also increase the risk of workplace accidents (Sorenson, Bolick, Wright Hamilton, 2016). These accidents are often misinterpreted as carelessness by the staff. However, such carelessness often results due to excessive amount of fatigue present in the workers. Thus, the ergonomics or the workplace infrastructure are some other contributing factors and needs to be worked upon. As commented by Hassard et al. (2014), providing the staff with proper resting areas can help them to relax and unwind. Additionally, some of the other factors are provision of adequate facilities such as clean drinking water, changing rooms. Reports and evidence have suggested that providing the nursing professionals with suitable ergonomics can also help in reducing the grievances faced by them (Cheng Cheng, 2017). As commented by Harris, Sims, Parr Davies (2015), sufficient counselling and training could help the nursing professionals in coping up with increasing tension and work pressure. The training has also been seen to generate sufficient motivation in the staffs (Munabi, Buwembo, Kitara, Ochieng Mwaka, 2014). In this respect, providing the staff with performance bonus and incentives has also been seen to generate sufficient motivation within the staffs. Feasibility of the research In order to conduct a research successfully the feasibility options for conducting the research successfully have to be taken into consideration. In the current study, we have used both survey and questionnaire for the collection of relevant data regarding the increased absence of nursing staff from their place of work. Some of the feasibility issues which were faced by the researcher in conducting the survey and the interview were getting proper support from the management and the nursing staffs. Additionally, being at an arm's length from the hospices also affected the data collection procedure. The remote locations of some of the hospitals also resulted in accessibility issues, which further affected the authenticity of the results. Time The timing is a very important factor in ensuring the rate of success of a research project. In this respect, the limited time allotted for conducting the research study limited the scope of the research. Since the research had to be conducted within the hospital premises; therefore prior consent had to be taken from the respondents of the survey and interview process. Otherwise, any interruption within a busy hospital setting would have been considered as a violation of the research ethics and practices (Byrne Martin, 2014). Cost The budget allocation and costs associated with conducting a research project also have significant impact on the success rate of the project. The allocation of the budget could be done based upon the set of activities which are to be performed for the process of data collection and evaluation. A data plan entailing the amount spent upon each component of the research has been provided below. Activities Figures (in singapore dollars) Advertising (online promotion, designing posters, templates) S$ 0.2 million On field expenses (organizing surveys) S$ 0.3 million Research (collection of primary and secondary data about the issues faced by theworking professionals in healthcare) S$ 0.2 million Fundraising activities (inviting tenders, expression of interest) S$ 0.5 million Table 1: budget allocation (Source: author) Adverse events The adverse events in the context of healthcare could be described as any untoward incident that may occur during the process of care delivery by the nursing professionals. Some of the common phenomena which could be described over here are overdosing of patients by the fatigues or tired nursing staffs. The reporting of the adverse events can help in the identification of organizational, systematic and environmental problems (Ganster Rosen, 2013). There are a number of methods of reporting the adverse events including document review and surveillance of the clinical data. Therefore, the detailed analysis of the clinical data would help in analysing the factors which contributes towards increased rate of absentees among the nursing staffs. Database: NCBI, Pubmed, Cochrane library, MEDLINE. Is lack of sleep the cause behind increased rate of sickness absences in nursing staffs? Search topic Number of hits generated Workplace stress 52 Effect of stress on the physical and mental health of nursing staffs 65 Stress on absenteeism in workplace 50 Work life balance in improving health of the nursing staff 42 Systematic reviewed journals only 40 Limit the journals to last ten years only 35 Limit the journals to English language only 40 Table: search criteria (Source: Author) The literature has been supported through evidences from Randomised control trials (RCT) methods which belong to level 1 of evidence based studies. Effect size The effect size in a pilot study is a hypothetical focus group considered by the researcher initially which helps him in conducting a priori sample size calculation for future larger study. It further helps in the development of adequate statistical knowledge in the researcher. Methodology of the research The research had been conducted with the help of primary mixed methods (quantitative and qualitative research design). Here, quantitative study has been conducted with the help of designing a survey questionnaire. In this respect, an open-ended questionnaire is been presented to the health care staffs working in the hospital. The questions are designed pertaining to work-life balance, availability of growth opportunities, sufficient perks and incentives. The responses collected are used to design statistically significant results. Additionally, an interview is conducted by the hospital managers where the nursing staffs are questioned regarding the benefits of reducing shift hours on their physical and mental health. The comparative analysis helps in arriving at sufficiently evidence-based results. The methodology of the research has been further discussed with the help of individual research parameters as philosophy of the research, design, approach, strategy, type, data collection, data analysis, ethical and accessibility issues. Research approach There are two different types of research approaches such as inductive and deductive approaches. A thin line of difference lies between the two approaches being followed by the research methodology. In the current study, we have taken into consideration both the research approaches. The deductive approach is based upon testing an already published hypothesis whereas an inductive approach is concerned with new theory generation form the emerging data. The deductive approach is considered for quantitative studies; whereas the inductive approach is considered for conducting a qualitative study (Selamu et al., 2017). In the following assignment, we have taken into consideration both quantitative and qualitative study design. In the current study, we have conducted both survey and interviews for the purpose of data collection. Therefore, we have taken into consideration both the research methods and approaches. Sampling There are two main types of sampling methods such as simple random sampling methods and non-random sampling methods. In random sampling methods, we are providing each and every respondent equal opportunity to participate in the data collection process. In case of non-random sampling one generally follows a purposive mode of selection of the focus group for conducting the survey or the interview. For the current study design, we have followed a simple random sampling method. This provides every respondent equal opportunity of participating in the interview process. Here, the nursing staffs have been divided into two group where one of the groups have been put into twelve hours long shifts(control group) and the other group had been put into 8 to 9 hours shift (intervention group). The control and the intervention groups of nursing staffs have been reversed and vice-versa. The process has been executed for a period of four months and the comparative data collected for further analysis. Data collection The data collection is the most crucial part of a research project based upon which the entire evaluation is done. For the current study, primary data collection methods have been chosen. The primary design of data collection could be further divided into quantitative and qualitative methods. The quantitative data are collected through tools such as survey questionnaire. The responses collected through the survey questionnaire are represented into statistically significant results such as graphs and charts. Data analysis For the analysis of the data of primary mixed research design had been followed where the data have been collected through both interviews and surveys. In this respect, the recordings of the interview had been made into transcripts (Selamu, Thornicroft, Fekadu Hanlon, 2017). The statistically significant results collected through the survey are compared with the interview transcripts to arrive at cumulative responses. Research ethics A number of ethical considerations had to be taken into consideration during the conduct of the research. Some of the factors include taking proper consent from the respondents participating in the survey and interview process. In this respect, the participants have to be informed much in advance regarding the venue, timing of the interview process. The respondents could be reached over through a mail or by giving gentle reminders on the phone. In this respect, utmost care should be taken that none of the participants is forced to participate in the data collection process. Additionally, the entry and exit to the interview methods were kept open; that is the respondents were free to leave the premises of the interview at any point in time. With respect to reporting of adverse events, the survey respondents or participants of the interview need to given sufficient room for safeguarding their personal details. The Singapore Personal Data Protection Act (2012), ensures that confidential ity concerns of the participants are maintained and no personal data are shared without their consent ("About SingHealth - Singapore's Largest Healthcare Group - Singapore Health Hospitals and Doctors", 2018). Evidence in support of decisions and approaches For the dissemination of the objectives related to the pilot study, a number of steps could be followed. Firstly, strict rules limiting extensive work hours of the nursing professionals need to be imposed as per regulatory bodies such as ACGME. In the context of long working hours, the nurses need to be provided with sufficiently longer breaks, which would help them relax and freshen up before the next shift. In this respect, meetings could be organized with the board of directors giving them exact figures and statistics regarding the rates of untoward incidents which happen due to negligence at the time of delivery of duty by the overtired staffs. A well-entailed study of the past could be taken as an example for highlighting the problem areas where sufficient reforms and measures need to be implemented. The lack of proper scheduling during the roster preparation of the nurses can also lead to mishaps within healthcare settings. In this respect, steps could be taken to reduce the nu mber of consecutive rotational shifts within a single day for a nursing professional. This could be established by providing a sufficient number of backups and involving more number of staffs within the care procedure. Therefore, emphasis needs to be placed upon hiring and recruitment of more number of nursing professionals. In order to support the above-mentioned facts detailed study had been conducted with the help of sufficient literature analysis. Here, a number of questions related to compassionate fatigue have been asked to the participants of the survey and interview process as it is a common phenomenon among nursing staffs. In this respect, recurrent health checkups of the nursing professionals have been conducted. The results from repeated randomised control trials (RCTs) have shown that the healthcare staffs exposed to long duty hours reported gradual deterioration of health. The details from such health tests pointed at sudden increase in the blood glucose level and amount of hypertension. Therefore, sufficient measures need to be taken for checking and preventing rapid deterioration in the health of the nursing staffs. The concerned staffs could be provided with longer holidays for once in a while; which helps them in refreshing and rejuvenation. Discussion of barriers in implementation of the research objectives The current research has been designed with a view to investigating the claims of the manager who stated that inconscessantly long working hours contributes significantly to deteriorating the health conditions of the nursing professionals. For the dissemination of the objectives of the research project, a detailed qualitative and quantitative study method had been followed over here. In this respect, the individuals or participants taking part in the study design need to be informed well in advance regarding the venue, dates and timing of the interview process. Additionally, the personal and private details of the participants need to be preserved so that no confidential information is leaked out or misinterpreted. The consent from the respondents needs to be attained on signed papers highlighting in full details the terms and conditions of the survey process. In order to conduct the interview three different management lines of the organisation will be chosen such as the frontline manager, middle-level manager and the executive manager. The interview responses and later retrospection helps in highlighting the loopholes within the system and administration which are crucial in providing the staffs with a proper work-life balance. However, there are a number of barriers which are faced in the conduct of the research study. Some of the factors which play a governing role in the success of the research project are cost and timing of conducting the research. For designing of the interview and study design support and funding from the state and federal level is required. The entire consent and approval cycle takes huge amount of time which could have been otherwise vested in gathering sufficient and authentic data for the research project. Conclusion The current research project evaluates the effect of long working hours on the health of the various staffs and healthcare professionals. The study conducted here analyses the various factors which contribute towards the development of conditions where the nursing professionals have been absent from their work for a longer period of time. Further study and analysis have supported the supported and drawn various links between errors within the hospital and care set up and overworked staff. In the current study, a mixed research methodology has been followed for gathering and collection of sufficient data supporting the hypotheses. In this respect, implementation of alternative strategies and solutions such as provision of longer break hours along with paid holidays, work-based incentives can help in generating sufficient motivation in the staff. Additionally, providing the nurses with free health check-ups regularly can also reduce the occurrence of mishaps within a care setup. References About SingHealth - Singapore's Largest Healthcare Group - Singapore Health Hospitals and Doctors. (2018). Singhealth.com.sg. Retrieved 6 January 2018, from https://www.singhealth.com.sg/AboutSingHealth/Pages/Home.aspx Allen, B. C., Holland, P., Reynolds, R. (2015). The effect of bullying on burnout in nurses: the moderating role of psychological detachment.Journal of advanced nursing,71(2), 381-390. DOI: 10.1111/jan.12489 Arnold, R., Teijlingen, E., Ryan, K., Holloway, I. (2015). 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