On SAGE Insight: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings


Article title: Alert Workplace From Healthcare Workers’ Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings

From HERD: Health Environments Research & Design Journal

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Sleepiness, and loss of alertness, is a common problem for healthcare workers and may decrease cognitive performance, lower mood and increase the risk of errors and incidents, directly and indirectly affecting both patients and staff. Sleepiness and the related reduced cognitive performance of medical personnel have been associated with an increased risk of procedural, diagnostic, and medication errors as well as an increased risk of injuries such as needle sticks.

This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness. Researchers surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively.

Currently, healthcare staff primarily opt for caffeine to keep alert at work. Although caffeine consumption increases alertness and improves reaction time, it has the downside of lowering one’s mood following its withdrawal/ Caffeine consumption may also increase the risk of high blood pressure for medical professionals who are under high stress. In summary combining the workers’ point of view with past evidence, several strategies that could be encouraged by administrators and managers are as followed: promoting good dietary choices (limiting sugar and caffeine); encouraging physical mobility; providing sensory, social, or cognitive stimulation at work through environment and activities; providing mini rest or nap opportunities; and educating staff on personal lifestyle and wellness strategies. Physical spaces that provide daylight and thermal comfort are likely to maximize workplace alertness. Typical healthcare workspaces are windowless, with unchanging light, airflow, and temperature, and designed with deep floor plates that creates difficult access to outdoors or fresh air, which creates a monotonous environment that is at odds with evidence-based recommendations.

Abstract

Objective:

This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety.

Background:

Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries.

Method:

We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively.

Results:

In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness (p < .05).

Conclusions:

By optimizing the physical environment and organizational policies and providing education programs, we have an opportunity to support healthcare professionals in managing sleepiness and maintaining alertness at work. In addition, such system level interventions may reduce unhealthy choices such as frequent caffeine intake to keep alert. The development of multidisciplinary evidence-based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

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Article details

Alert Workplace From Healthcare Workers’ Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings
Rana Sagah Zadeh, Mardelle Shepley, Hessam Sadatsafavi, Arthur Hamie Owora, Ana C. Krieger,
First Published October 10, 2017 Research Article
DOI: 10.1177/1937586717729349
From HERD: Health Environments Research & Design Journal

     
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