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        The National Institute for Occupational Safety and Health (NIOSH)
        The National Institute for Occupational Safety and Health (NIOSH)
        Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People The National Institute for Occupational Safety and Health (NIOSH)
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    The National Institute for Occupational Safety and Health (NIOSH)
      * Learning Objectives
      * About the Training Program
      * Foreword
      * Accreditation Statement
      * Part 1. The Risks and Why These Occur
              + BACK
                Part 1. The Risks and Why These Occur
          + Module 1. Introduction
                  o BACK
                    Module 1. Introduction
                  o BACK
                    Part 1. The Risks and Why These Occur Module 1. Introduction
              o Introduction (Continued)
              o Benefits
              o Benefits (Continued)
              o Benefits (Continued)
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 2. How shift work and long work hours increase health and safety risks
                  o BACK
                    Module 2. How shift work and long work hours increase health and safety risks
                  o BACK
                    Part 1. The Risks and Why These Occur Module 2. How shift work and long work hours increase health and safety risks
              o Objectives (Continued)
              o Sleep is a Basic Need
              o Your Body is Busy During Sleep
              o Sleep and the Immune System
              o Sleep and the Immune System (Continued)
              o Impacts on Metabolism and Endocrine Function
              o How Much Sleep Do You Need?
              o Epworth Sleepiness Scale
              o Regulation of Sleep: A Simple, Two-Process Model
              o Sleep Pressure: Homeostatic Sleep Drive
              o Sleep Pressure: Homeostatic Sleep Drive (Continued)
              o Circadian Rhythms
              o Circadian Rhythms (Continued)
              o Circadian Rhythms That Promote Wakefulness
              o Synchronization of Homeostatic and Circadian Processes
              o Desynchronization of Homeostatic and Circadian Processes
              o Circadian Rhythms
              o Effects of Light on Circadian Rhythms
              o The Color of the Light Affects Circadian Rhythms
              o Afternoon Dip in Wakefulness
              o Be Alert for Key Factors that Promote Fatigue!
              o Be Aware of the Dangers of Sleepiness and Fatigue
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 3. Risks associated with shift work and long work hours
                  o BACK
                    Module 3. Risks associated with shift work and long work hours
                  o BACK
                    Part 1. The Risks and Why These Occur Module 3. Risks associated with shift work and long work hours
              o Negative Impacts on Sleep
              o Microsleeps
              o Functioning
              o Functioning (Continued)
              o Functioning (Continued)
              o Common and Critical Misconceptions and Individual Differences
              o Impairments due to sleep deprivation are similar to impairments due to alcohol intoxication!
              o Injuries/Errors
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Health Behaviors
              o Diseases and Shift Work
              o Cardiovascular Disease
              o Gastrointestinal Disorders
              o Psychological Complaints
              o Cancer
              o Diabetes Mellitus
              o Reproductive Outcomes
              o Some people cannot seem to be able to adjust to shift work
              o Diseases and Long Hours
              o Musculoskeletal Disorders
              o Impacts on Families
              o Impacts on Employers
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 4. Individual differences
                  o BACK
                    Module 4. Individual differences
                  o BACK
                    Part 1. The Risks and Why These Occur Module 4. Individual differences
              o Sleep Differences
              o Larks/Owls
              o Age
              o Chronic Disorders
              o Chronic Disorders (Continued)
              o Work/Home Demands
              o Quiz
              o References
              o Part 1 Course Completion and Evaluation
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + The National Institute for Occupational Safety and Health (NIOSH) Home
      * Part 2. Strategies to Reduce Risks
              + BACK
                Part 2. Strategies to Reduce Risks
          + Module 5. Work Organization Strategies to Promote Alertness and Health in Nurses
                  o BACK
                    Module 5. Work Organization Strategies to Promote Alertness and Health in Nurses
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 5. Work Organization Strategies to Promote Alertness and Health in Nurses
              o Objectives (Continued)
              o Key Points
              o Improving Work Schedules
              o Researchers have proposed these guidelines for designing work schedules
              o Researchers have proposed these guidelines for designing work schedules: (Continued)
              o Extended Shifts
              o Extended Shifts (Continued)
              o Extended Shifts (Continued)
              o Rest Breaks
              o Planned Naps
              o Periodic Assessments
              o Organizational Improvements
              o Workload Level Analysis
              o Supervisor Support
              o Create a Positive Atmosphere
              o Fatigue Risk Management Systems
              o Liabilities and Responsibility
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 6. Improving Your Sleep and Alertness
                  o BACK
                    Module 6. Improving Your Sleep and Alertness
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 6. Improving Your Sleep and Alertness
              o Create a Good Sleep Environment
              o Create a Good Sleep Environment (Continued)
              o Prepare for Sleep
              o Timing Sleep to Fit Your Work Schedule
              o Using light
              o Improve Sleep by Avoiding Light
              o Exercise
              o Sleep Aids and Stimulants
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o A Test Dose Might Be Helpful
              o Do You Have Symptoms of a Sleep Disorder?
              o Do You Have Symptoms of a Sleep Disorder? (Continued)
              o Do You Have Symptoms of a Sleep Disorder? (Continued)
              o Improve Other Sources of Sleepiness
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 7. Napping, an Important Fatigue Countermeasure
                  o BACK
                    Module 7. Napping, an Important Fatigue Countermeasure
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 7. Napping, an Important Fatigue Countermeasure
              o Introduction
              o Sleep Inertia
              o Nap Times
              o Nap Duration
              o Before Nights
              o Naps at Work
              o Naps at Work (Continued)
              o Work Setting
              o Work Setting (Continued)
              o Work Setting (Continued)
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 8. Day Shift
                  o BACK
                    Module 8. Day Shift
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 8. Day Shift
              o Day Shift Challenges
              o Using Light to Promote a Better Morning Wake-Up Time and Sleepiness in the Evening
              o Using Light to Promote a Better Morning Wake-Up Time and Sleepiness in the Evening (Continued)
              o To Increase Alertness
              o Planning Bedtime
              o Relaxation Techniques
              o Relaxation Techniques (Continued)
              o Relaxation Techniques (Continued)
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 9. Coping with the Night and Evening Shifts
                  o BACK
                    Module 9. Coping with the Night and Evening Shifts
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 9. Coping with the Night and Evening Shifts
              o Nights Difficult
              o Light
              o Light (Continued)
              o Sleep
              o Sleep (Continued)
              o Evening Shift
              o Diet Suggestions for Night-Shift Nurses
              o Diet Suggestions for Night-Shift Nurses (Continued)
              o Diet Suggestions for Night-Shift Nurses (Continued)
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 10: Coping Strategies for Your Personal Life
                  o BACK
                    Module 10: Coping Strategies for Your Personal Life
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 10: Coping Strategies for Your Personal Life
              o Family and Social Life
              o Educate Family and Friends
              o Tell your family and friends what they can do to help
              o Planning Suggestions
              o Maintain contact with family and friends
              o Communicate Schedule Information
              o Communicate times you need to sleep
              o Childcare
              o Suggestions for holidays and special occasions
              o Choose carefully where to live and work
              o Strategies to Cope with High Demands from Work and Home
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 11. Driving
                  o BACK
                    Module 11. Driving
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 11. Driving
              o Drowsy Driving
              o Warning Signs
              o Preventing Crashes
              o Preventing Crashes (Continued)
              o Quiz
              o References
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + Module 12. Action Steps and Final Comments
                  o BACK
                    Module 12. Action Steps and Final Comments
                  o BACK
                    Part 2. Strategies to Reduce Risks Module 12. Action Steps and Final Comments
              o Action Steps for Nurses on Shiftwork
              o Education
              o Plan for Work and Family Responsibilities
              o Get Regular Checkups and Take Care of Yourself
              o Action Steps for Nurse Managers
              o Action Steps for Nurse Managers (Continued)
              o Action Steps for Nurse Managers (Continued)
              o Final Comments
              o References, Authors & Acknowledgments
              o Congratulations! You have completed Part 2 of NIOSH Training for Nurses on Shift Work and Long Work Hours.
              o The National Institute for Occupational Safety and Health (NIOSH) Home
          + The National Institute for Occupational Safety and Health (NIOSH) Home
      * Other Resources
      * The National Institute for Occupational Safety and Health (NIOSH) Home
          The National Institute for Occupational Safety and Health (NIOSH)
    The National Institute for Occupational Safety and Health (NIOSH) Home
        NIOSH Training for Nurses on Shift Work and Long Work Hours
          Rest Breaks
        Print
            Related Pages
              Rest Breaks
                  Taking rest breaks at least every 2 hours during work shifts will reduce the risk for on-the-job injuries and errors.21
              Arlinghaus and colleagues have shown a clear dose-response relationship between rest breaks and on-the-job injuries: longer total time on breaks was significantly related to longer time spent on work tasks without having an injury.22
              Lombardi and colleagues found that after taking breaks, workers on day shift went longer without an injury than did workers on evening and night shifts.23 In this study, workers on evening and night shifts had poorer sleep quality and shorter sleep duration than day shift workers. This can put them at higher risk for fatigue, errors, and injuries. Therefore, it may be especially helpful for workers on evening and night shifts to have additional breaks or longer time on breaks.
              Managers can systematically promote meal and rest breaks during work shifts. At the beginning of the shift, managers can schedule the breaks along with the other work assignments. During the shift, they can encourage nurses to take their breaks and create a system for coverage of their duties while on break.
              Consider planning enriched breaks that include activities such as
                * Exercise or stretching
                * Novel or amusing diversions.
              Researchers do not know how long the alerting effect of a rest break lasts. Factors such as these influence their effect:
                * How long a person has been awake
                * The amount of sleep debt
                * The time of day (circadian effect)
                * Time on task (particularly with monotonous tasks).
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      Last Reviewed: March 31, 2020
        Source: National Institute for Occupational Safety and Health
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      home NIOSH Training for Nurses on Shift Work and Long Work Hours
      * Learning Objectives
      * About the Training Program
      * Foreword
      * Accreditation Statement
      * Part 1. The Risks and Why These Occur plus icon
          + Module 1. Introduction plus icon
              o Introduction (Continued)
              o Benefits
              o Benefits (Continued)
              o Benefits (Continued)
              o References
          + Module 2. How shift work and long work hours increase health and safety risks plus icon
              o Objectives (Continued)
              o Sleep is a Basic Need
              o Your Body is Busy During Sleep
              o Sleep and the Immune System
              o Sleep and the Immune System (Continued)
              o Impacts on Metabolism and Endocrine Function
              o How Much Sleep Do You Need?
              o Epworth Sleepiness Scale
              o Regulation of Sleep: A Simple, Two-Process Model
              o Sleep Pressure: Homeostatic Sleep Drive
              o Sleep Pressure: Homeostatic Sleep Drive (Continued)
              o Circadian Rhythms
              o Circadian Rhythms (Continued)
              o Circadian Rhythms That Promote Wakefulness
              o Synchronization of Homeostatic and Circadian Processes
              o Desynchronization of Homeostatic and Circadian Processes
              o Circadian Rhythms
              o Effects of Light on Circadian Rhythms
              o The Color of the Light Affects Circadian Rhythms
              o Afternoon Dip in Wakefulness
              o Be Alert for Key Factors that Promote Fatigue!
              o Be Aware of the Dangers of Sleepiness and Fatigue
              o Quiz
              o References
          + Module 3. Risks associated with shift work and long work hours plus icon
              o Negative Impacts on Sleep
              o Microsleeps
              o Functioning
              o Functioning (Continued)
              o Functioning (Continued)
              o Common and Critical Misconceptions and Individual Differences
              o Impairments due to sleep deprivation are similar to impairments due to alcohol intoxication!
              o Injuries/Errors
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Injuries/Errors (Continued)
              o Health Behaviors
              o Diseases and Shift Work
              o Cardiovascular Disease
              o Gastrointestinal Disorders
              o Psychological Complaints
              o Cancer
              o Diabetes Mellitus
              o Reproductive Outcomes
              o Some people cannot seem to be able to adjust to shift work
              o Diseases and Long Hours
              o Musculoskeletal Disorders
              o Impacts on Families
              o Impacts on Employers
              o Quiz
              o References
          + Module 4. Individual differences plus icon
              o Sleep Differences
              o Larks/Owls
              o Age
              o Chronic Disorders
              o Chronic Disorders (Continued)
              o Work/Home Demands
              o Quiz
              o References
              o Part 1 Course Completion and Evaluation
      * Part 2. Strategies to Reduce Risks plus icon
          + Module 5. Work Organization Strategies to Promote Alertness and Health in Nurses plus icon
              o Objectives (Continued)
              o Key Points
              o Improving Work Schedules
              o Researchers have proposed these guidelines for designing work schedules
              o Researchers have proposed these guidelines for designing work schedules: (Continued)
              o Extended Shifts
              o Extended Shifts (Continued)
              o Extended Shifts (Continued)
              o Rest Breaks
              o Planned Naps
              o Periodic Assessments
              o Organizational Improvements
              o Workload Level Analysis
              o Supervisor Support
              o Create a Positive Atmosphere
              o Fatigue Risk Management Systems
              o Liabilities and Responsibility
              o Quiz
              o References
          + Module 6. Improving Your Sleep and Alertness plus icon
              o Create a Good Sleep Environment
              o Create a Good Sleep Environment (Continued)
              o Prepare for Sleep
              o Timing Sleep to Fit Your Work Schedule
              o Using light
              o Improve Sleep by Avoiding Light
              o Exercise
              o Sleep Aids and Stimulants
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o Sleep Aids and Stimulants (Continued)
              o A Test Dose Might Be Helpful
              o Do You Have Symptoms of a Sleep Disorder?
              o Do You Have Symptoms of a Sleep Disorder? (Continued)
              o Do You Have Symptoms of a Sleep Disorder? (Continued)
              o Improve Other Sources of Sleepiness
              o Quiz
              o References
          + Module 7. Napping, an Important Fatigue Countermeasure plus icon
              o Introduction
              o Sleep Inertia
              o Nap Times
              o Nap Duration
              o Before Nights
              o Naps at Work
              o Naps at Work (Continued)
              o Work Setting
              o Work Setting (Continued)
              o Work Setting (Continued)
              o Quiz
              o References
          + Module 8. Day Shift plus icon
              o Day Shift Challenges
              o Using Light to Promote a Better Morning Wake-Up Time and Sleepiness in the Evening
              o Using Light to Promote a Better Morning Wake-Up Time and Sleepiness in the Evening (Continued)
              o To Increase Alertness
              o Planning Bedtime
              o Relaxation Techniques
              o Relaxation Techniques (Continued)
              o Relaxation Techniques (Continued)
              o Quiz
              o References
          + Module 9. Coping with the Night and Evening Shifts plus icon
              o Nights Difficult
              o Light
              o Light (Continued)
              o Sleep
              o Sleep (Continued)
              o Evening Shift
              o Diet Suggestions for Night-Shift Nurses
              o Diet Suggestions for Night-Shift Nurses (Continued)
              o Diet Suggestions for Night-Shift Nurses (Continued)
              o Quiz
              o References
          + Module 10: Coping Strategies for Your Personal Life plus icon
              o Family and Social Life
              o Educate Family and Friends
              o Tell your family and friends what they can do to help
              o Planning Suggestions
              o Maintain contact with family and friends
              o Communicate Schedule Information
              o Communicate times you need to sleep
              o Childcare
              o Suggestions for holidays and special occasions
              o Choose carefully where to live and work
              o Strategies to Cope with High Demands from Work and Home
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Strategies to Cope with High Demands from Work and Home (Continued)
              o Quiz
              o References
          + Module 11. Driving plus icon
              o Drowsy Driving
              o Warning Signs
              o Preventing Crashes
              o Preventing Crashes (Continued)
              o Quiz
              o References
          + Module 12. Action Steps and Final Comments plus icon
              o Action Steps for Nurses on Shiftwork
              o Education
              o Plan for Work and Family Responsibilities
              o Get Regular Checkups and Take Care of Yourself
              o Action Steps for Nurse Managers
              o Action Steps for Nurse Managers (Continued)
              o Action Steps for Nurse Managers (Continued)
              o Final Comments
              o References, Authors & Acknowledgments
              o Congratulations! You have completed Part 2 of NIOSH Training for Nurses on Shift Work and Long Work Hours.
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