BACKGROUND: Shift work and resulting sleep impairment among nurses can increase their risk for poor health outcomes, occupational injuries, and errors due to sleep deficiencies. While sleep education and training for nurses has been recommended as part of a larger fatigue risk management system, little is known about training programs designed specifically for nurses. OBJECTIVE: Investigate the literature for current sleep education or training programs specifically for shift working nurses, with intent to assess training content, delivery characteristics, and outcome measures. DESIGN: A scoping review conducted October 2020 through September 2021. METHODS: The bibliographic databases Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, PubMed, and NIOSHTIC-2 were searched using words such as "nurse," "sleep hygiene," "shift work," and "education". Studies were included if they: 1) were original research; 2) discussed sleep education, training, or sleep hygiene interventions; 3) included a study population of nurses engaging in shift work; 4) focused on sleep as a primary study measure; 5) were written in English language; and 6) were published in 2000 or later. RESULTS: Search results included 17,237 articles. After duplicates were removed, 14,620 articles were screened. Nine articles were found to meet established criteria. All studies included sleep hygiene content in the training programs, with five studies adding psychological and/or behavior change motivation training to support change in nurse sleep habits. Three studies added specific training for nurses and for managers. Delivery modes included in-person training of various lengths and frequency, mobile phone application with daily engagement, an online self-guided presentation, and daily reading material coupled with audio training. Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale were the outcome measures most frequently used. Although studies demonstrated improved sleep measures, most were pilot studies testing feasibility. CONCLUSION: Although there is a paucity of studies focused on sleep education and training for shift working nurses, we found the inclusion of sleep hygiene content was the only common characteristic of all nine studies. The variability in training content, delivery methods, and outcome measures suggests further research is needed on what constitutes effective sleep education and training for nurses.

To evaluate the association between shift work and risk of type 2 diabetes mellitus, we searched PubMed, EMBASE and Web of Science from their inception to June 8, 2019. Observational studies examining the relationship between shift work and type 2 diabetes were included. Subgroup analyses were conducted to explore whether specific characteristics would affect the relationship. A dose-response relationship was estimated by using generalized least squares trend regression. Finally, twelve cohort studies and nine cross-sectional studies were included (inter-rater agreement, k = 0.96). The result of meta-analysis indicated that shift work was associated with an increased risk of type 2 diabetes (relative risk = 1.10, 95% confidence interval = 1.05-1.14). Subgroup analyses demonstrated that female shift workers have increased risk of type 2 diabetes while male not observed, health care workers showed the highest risk compared with civil servants and manual workers, and night shift and rotating shift were associated with an increased risk of type 2 diabetes. Dose-response meta-analysis based on three cohorts among female workers indicated that there might be a positive association between duration of shift work and the risk of type 2 diabetes. In conclusion, shift work is positively associated with an increased risk of type 2 diabetes. Among female workers, with the years of exposure to shift work prolonged, the risk of type 2 diabetes might increase accordingly. In the future, more studies are needed to confirm the results of dose-response analysis.

AIM: To systematically evaluate the effect of work schedule characteristics on fatigue among shift nurses in hospital settings. BACKGROUND: The complexity and multidimensional nature of nursing work may lead to fatigue. This review mainly focused on work schedule characteristics that may mitigate the fatigue in nurses. EVALUATION: Six databases were searched and 8 relevant research articles published between 2000 and 2018 were identified. KEY ISSUES: The reviewed articles provided some evidence supporting the association of work schedule characteristics such as total working hours, overtime, shift length, and number of monthly night and evening shifts with fatigue. In addition, studies provided evidence for the positive association between insufficient rest period between shifts and fatigue among shift nurses in hospital settings. CONCLUSION: The reviewed studies provided mixed results regarding the associations between work schedule characteristics and nurse fatigue. However, quick returns and days called to work on days off were consistent factors contributing to nurse fatigue. More evidence is needed to arrive at a definitive conclusion about such relationships. IMPLICATION FOR NURSING MANAGEMENT: Nursing managers and administrators need to carefully review current rotating shift system and examine its impact on nurse fatigue as well as ensure enough resting time when developing nurse schedules. This article is protected by copyright. All rights reserved.

AIMS: To synthesize research on the influence of night-shift napping on nurses. BACKGROUND: Shift work is common for hospital nurses. Various studies corroborate that shift work causes adverse health consequences for nurses. Night-shift napping is a countermeasure to address the adverse outcomes of shift work. DESIGN: A mixed-methods systematic review. DATA SOURCES: The literature search included the PubMed, Web of Science, Embase, PsycINFO and Cochrane Library electronic databases from inception to December 2017. Reference lists were hand searched. Only English articles were chosen. REVIEW METHODS: A sequential explanatory design and Cochrane`s methods for integrating qualitative and implementation evidence in intervention effectiveness reviews. The Mixed Methods Assessment Tool and Cochrane Risk of Bias Tool were applied to assess the methodological quality of included studies. RESULTS: Twenty-two studies met our inclusion criteria. Many nurses experienced napping during their night-shift although no clear policy emerged. Napping is beneficial to the well-being of nurses and could improve their psychomotor vigilance and performance. However, the related studies are limited. The evidence on reducing sleepiness and fatigue was also insufficient and napping in nursing still faces challenges. CONCLUSION: Although research on this topic has just started, napping during night-shift is beneficial to nurses` health and performance. Research should further explore the long-term impact on of night-shift napping on nurses, people and organization using sound methodological designs. Managers should actively develop strategies to address night-shift napping barriers.