Journal Article

Utjecaj noćnog rada na zdravlje medicinskih sestara

Tepavac, Milica, Brborović, Hana, Brborović, Ognjen

2025

Overview

Zdravstvena zaštita u Republici Hrvatskoj organizirana je na primarnoj, sekundarnoj, tercijarnoj te razini zdravstvenih zavoda. Većina medicinskih sestara i tehničara radi na sekundarnoj i tercijarnoj razini koja uključuje kontinuiranu 24-satnu skrb te je iz tog razloga i najveći broj medicinskih sestara i tehničara izloženo utjecaju noćnog rada. Noćni rad utječe na zdravlje na način da dovodi do deprivacije sna, umora, rizika za psihičke i fizičke smetnje te bolesti, ali i poremećaje u socijalnom i obiteljskom životu. Pretražene su 3 baze podataka: Pubmed, Google scholar i Proquest; kriterij za odabir bio je sustavni pregled literature i meta analiza, a u obzir su dolazili samo članci na engleskom jeziku. Pregled literature rađen je prema PRISMA smjernicama, kvaliteta članaka ocijenjena je AMSTAR-R instrumentom za ocjenjivanje, pouzdanost između ocjenjivača napravljena je Cohenovim kappa koeficijentom, a kako bi se utvrdilo preklapanje korištene literature korištena je metoda ispravljenog pokrivenog područja (eng. Corrected Covered Area (CCA)). Pregledom sustavnih pregleda i meta analiza, rezultati prikazani u ovom radu dobiveni su iz 8 istraživanja od kojih su 3 sistematski pregled, a 5 meta analize, objavljivani između 2013. i 2021. godine iz različitih dijelova svijeta (Europa, Azija, Amerika, Australija, Afrika). Istraživanja su pokazala da noćni rad utječe na san medicinskih sestara u smislu smanjenja njegove kvalitete te na samo zdravlje u smislu povećanja rizika od povećane težine, razvoja metaboličkog sindroma, dijabetesa tipa 2, kardiovaskularnih bolesti, karcinoma dojke, bolova u leđima te povećanja unosa alkohola. Osim utjecaja na san i zdravlje medicinskih sestara, noćni rad može dovesti i do drugih rizika kako za medicinske sestre poput rizika od ubodnih incidenata, ozljeda i bolova, psihičkih i emocionalnih smetnji, željom za odlaskom te automobilskih nesreća, tako i za krajnje korisnike zdravstvene zaštite, a to su pacijenti, a odnose se na rizik od pogrešne administracije lijekova, dekubitusa, hipoglikemije, urinarne infekcije te bolničke infekcije. Potrebna su dodatna istraživanja povezana s problematikom noćnog rada kako za same rizike koje on donosi tako i za utjecaj potencijalnih rješenja na iste. Osim toga, potrebna je trajna edukacija medicinskih sestara o ovom problemu kako bi se na vrijeme prepoznale posljedice, na njih pravovremeno reagiralo te na taj način smanjile dugoročne posljedice na zdravlje. Nužno je i kontinuirano praćenje zdravstvenog stanja te poboljšanje radnih uvjeta u skladu s procjenom rizika pojedinog radilišta. Health care in the Republic of Croatia is organized at the primary, secondary, tertiary and health care institutions. Most nurses and technicians work at the secondary and tertiary levels, which includes continuous 24-hour care, and for this reason most nurses and technicians are exposed to night work. Night work affects health in a way that leads to sleep deprivation, fatigue, risk of mental and physical disorders and illnesses, but also disturbances in social and family life. 3 databases were searched: Pubmed, Google scholar and Proquest, the selection criteria were a systematic review of the literature and meta-analyzes, and only articles in English were considered. The literature review was performed according to PRISMA guidelines, the quality of the articles was evaluated by the AMSTAR-R evaluation instrument, the reliability between evaluators was made by the Cohen kappa coefficient, and the Corrected Covered Area (CCA) method was used to determine the overlap of the used literature. )). A review of systematic reviews and meta-analyzes, the results presented in this paper were obtained from 8 studies, 3 of which are systematic reviews, and 5 meta-analyzes, were published between 2013 and 2021 from different parts of the world (Europe, Asia, America) , Australia, Africa). Research has shown that night work affects nurses' sleep in terms of reducing its quality, and health itself in terms of increasing the risk of weight gain, developing metabolic syndrome, type 2 diabetes, cardiovascular disease, breast cancer, back pain and increasing alcohol intake. In addition to the impact on nurses' sleep and health, night work can lead to other risks for nurses, such as the risk of needlestick incidents, injuries and pain, mental and emotional disturbances, the desire to leave and car accidents, and for end users of health care, which are patients, risk of mismanagement of drugs, pressure ulcers, hypoglycemia, urinary tract infections and nosocomial infections. Additional research is needed related to the issue of night work, both with the risks it brings and the impact of potential solutions on them. Continuous education of nurses on this problem is needed in order to timely recognize the consequences of responding to them in a timely manner and thus reduce long-term health consequences. It is also necessary to continuously monitor the health condition and improve working conditions in accordance with the risk assessment of each site.

• Publisher: Croatian Association of Technical Examiners,Zavod za istraživanje i razvoj sigurnosti d.d,Hrvatska udruga tehničkih ispitivača
• Subject: Back pain / Cardiovascular diseases / Diabetes mellitus (non-insulin dependent) / Disturbances / End users / Fatigue / Health care / Hypoglycemia / Literature reviews / medicinske sestre, noćni rad, sustavni pregled, meta analiza / Metabolic disorders / Metabolic syndrome / Night shifts / Nighttime / Nosocomial infections / Nurses / nurses, night shift work, systematic review, meta analyze / Pain / Risk assessment / Shift work / Sleep deprivation / Systematic review / Technicians / Ulcers / Urinary tract / Working conditions