Li H, Shao Y, Xing Z, et al. Napping on night-shifts among nursing staff: A mixed-methods systematic review. J Adv Nurs. 2019 Feb;75(2):291-312. doi: 10.1111/jan.13859. Epub 2018 Nov 12. (Systematic review)

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.

Original Articles included in this ReviewReviews that include this article
Discipline Area Score
Nurse 6 / 7
Physician 5 / 7
Comments from MORE raters

Nurse rater

This is a sound literature search on a relevant and somewhat unexpected topic.

Nurse rater

Sleep makes a better nurse, even on night shift.

Nurse rater

Scholarly practitioners know this; many CNEs know this. How many hospital senior leaders embrace this concept - let alone managers actively develop strategies to remove napping barriers on their units? Imagine that nurses are napping while patients fall on the floor. Hospital reputation, liability, patient relations, and all the time spent on incident follow up make it almost impossible to talk about this in a community hospital.

Physician rater

The paper is not particularly well written. The methodology is not detailed enough, and the conclusions are sometimes more relevant to the state of the literature rather than the findings. The greatest value of this paper is the reference list which is a good starting place those wishing to read more on the topic

Physician rater

We need more evidence.

Physician rater

This is an interesting review on a relevant issue. It's worthwhile to note that only 3 RCT were included and only one of these showed a statistically significant positive effect of naps. Most studies were cross-sectional. An issue not addressed by the review is the statistical vs practical significance of the differences observed.
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