Improving Health and Nursing Practice through Translational Research

Introduction to The Issue

The identified issue in this research is the issue of long working hours of nurses and its impact on their health and the quality of services provided by them. The nurses are individuals that are adorned with the responsibility of monitoring and providing healthcare to the patients associated with them, it requires a diligent amount of rigour and a consistent amount of stamina. The nurses operate under a particular duration of working hour and a lack of management and segregation in work and energy conservation ratio may lead to the health-wise exhaustion of the nursing individual. And any kind of health hazard associated that may befall the nurse will directly affect the health of the patient associated with the nurse, through the form of lack of quality service (Rajan, 2017). A variety of dynamics have consolidated in hospital uses and employee patterns to establish increasingly dangerous patient care environments. The provision of healthy, reliable healthcare for hospitalised individuals face significant obstacles, along with quick entry and discharge rate and a lack of clinicians (Ball et al., 2017). While systemic institutional knowledge on patterns is scarce in nurses' employment for the amount of working hours allotted, qualitative reports show that the healthcare workers in facilities suffer from rigorous working hours with no breaks and a very minute amount of time to replenish the stamina that has been exhausted. Now, this research topic can be discussed with respect to Evidence based practice (EBP) to focus towards a focused and appropriate approach of research (Ballet al., 2017). The evidence- based practice approach will enable the research to be more diverse in terms of the discussion regarding the healthcare nursing individuals and their working hours with respect to the time management and division of labour (Caruso et al., 2017). As guidelines for extensive decision-making, many health care practitioners utilise both specific clinical experience and the latest empirical data. Without professional efficiency, the possibility of practise being perverted by data cannot extend or be promoted to a particular patient, even with the association of an outstanding external proof. The clinical threats soon grow redundant, at the cost of patients, lacking factual details. The competence and abilities of medical care practitioners are necessary since it relies on the clinical experience. A healthcare professional 's clinical competence is focused on the tenure of clinical expertise displayed by him, along with existing science and clinical literature awareness, and formal performance (Ballet al., 2017). Hence, we discuss the research the topic with respect to the three elements of the EBP. The first element comprises of the greatest evidences associated with the issue of the long working hours of the nurses. The analysis and discussion of these evidences will enable the research to take a more focused and specific approach. The second element of the research comprises of the experience and the expertise of the healthcare provider with respect to his/ her work schedule and time management awareness. The third element of the EBP approach comprises of the patients preferences. The proper management of the working hours of the nurses will ensure the patients to receive a greater amount of quality service. Hence, this lies in the greater interest of the patients. The incorporation of these elements with respect to the research will help the nurses achieve and plan a proper work schedule and take care of their respective patients (Carusoet al., 2017).

The Question and The Question Framework

The issue of extended or long working hours has been a persistent issue in many sectors. In the nursing sector, the nurses are responsible for the wellbeing of their clients and hence, any loss of stamina or concentration/ motivation that has been kindled in them, will reflect on the quality of healthcare provided to their patients. Hence, the research questioned can be formulated as follows,

  • What are the outcomes of the long nurse working hours on the patient health?
  • What are the interventions that can be discussed with respect to the long working hour issue?

The structure of the research questions is one of the most important aspect while conducting a research. They define and provide framework to the entire essence of the research. The research question will enable the researchers to properly and adequately discern into the analytical and comprehensive depth of the issue while considering various parameters related to it. Here, the PICO research method framework has been adapted with refers to the structure of problem/population, intervention, comparison and outcome. Through this methodology of research framework, the issue of long working hours with respect to the decisions of the nursing management can be discussed and evaluated properly. Thus, as per the PICO format, the problem will be the long working hours of the nurses, the intervention would the formulation of a proper working schedule by the management, the comparison would be the challenges faced due to that, and the outcome would be the incorporation of the three different elements of EBP.

The Search

The research methodology will comprise of a of a thorough and extensive analytical framework. The methodology that has been followed is qualitative. The qualitative approach of methodology enables the researchers to fetch reviews and articles from extensive journals and research papers concerning the topic, which gives rise to a systematic and authentic research, while addressing all the concerned angles. The research strategy will enable the researchers to properly analyse a more thorough and extensive array of facts and experiences, which will lead to the answers of the research questions (Eriksen and Frandsen, 2018).

The concerned research methodology will comprise of three aspects, key terms, the choice of databases and the Boolean key terms, they are explained as follows,

Key terms/ search terms- the research has to be conducted by reviewing different journals and articles concerning the research topic. To search about a particular topic or to transverse through that domain, the knowledge of appropriate key terms is necessary (Eriksenand Frandsen, 2018). The incorporation of appropriate key terms will give rise to a system of thorough and authentic search which will conveniently yield the result journals and articles surrounding the topic. The specific key words or search terms help in the segregation of the various parameters that are being used while researching a specific topics, without them, this would turn in a hectic job.

Problem/ population




The long working hours of the nurses/ Nurse population

Work schedule

The effects.

Patient healthcare.

Selecting a database of choice: Selecting a database of choice is one of the most crucial part of conducting a research. Research information is scattered over a vast domain of various types of researches. For this information to be accessed, a medium or a database is required. A database is a medium or a wide storehouse of different kinds of research data which can be ventured through the tool of key terms of search words. The information management method is the product of the desire to thrive in an innovation-dominated environment and the ability to maintain, with respect to the various parameters. Information is a three-stage process: production, maintenance and support. These in-turn contribute to the advancement of new insights, which, in turn, is driven by interdisciplinary bonds. This information needs to be communicated and researchers need to come up with a way to survive. This gives rise to the concept of databases. Databases may also be a means of encouraging value development and science development, in multiple fields of research (Eriksen and Frandsen, 2018).

The chosen databases in this case are Pubmed and Medline. The pubmed is an authentic biomedical database source which has been used by medical researchers for conducting thorough and extensive research over various medical domains. It sports a very efficient and manageable search structure along with an array of defining parameters to further fortify and focus the search (Manca et al., 2017). The medline is another authentic database primarily focusing on the research surrounding medicine and medical research. Both of these have been surveyed intensively to gather information and facts regarding the research topic. The authentic peer reviewed set of information and articles found in both the databases enable the researchers to further provide the necessary framework to their respective research (Mancaet al., 2017).

The search strategy: Various Boolean algebras have been used in the research to further narrow the search results and combine the key terms while treading through the databases. The AND logic gate is used to combine the search result for both the key terms. The OR logic gate function enables the researcher to select peer reviewed results from either one of the key terms. The NOT logic gate enables the user to select the first key term only while searching in a database.

Inclusion/ exclusion parameters: There are certain parameters that have been kept in mind while conducting the research. Few of those are, all the articles are taken from and after the year of 2016, this keeps the search results almost fresh and up to date. Only accessible articles have been considered. Only the articles in English language were selected.


Search term



(effect) AND (long working hours of nurses) AND (Work schedule)





Pubmed search strategy

Medline searching strategy

The Articles

The chosen articles are,

  • Working hours and health in nurses of public hospitals according to gender (Fernandes et al., 2017).

This article discusses and deals with the circumstances where the healthcare providers are suffering health ailments due to the issue of extra working hours. The purpose of this research was to determine, taking into account potential disparities of various gender identities, the overall health of the nurses of medical facilities who are doing long work hours (Fernandes et al., 2017).

  • Does work-induced fatigue accumulate across three compressed 12 hour shifts in hospital nurses and aides? (Thompson, 2019).

The research paper focuses on several aspects regarding the aspects of health of the nurses with respect to the high work load. Information of the occurrence and effects of exhaustion in the healthcare provider community has culminated in a significant need for improved understanding and successful management strategies. Recently, several recognised professional associations have issued advocacy statements and recommendations to raise consciousness of health workers' exhaustion and its effects, with the overarching goal of these associations to legitimise exhaustion as a significant and urgent problem (Thompson, 2019). The USA nursing corporation, for example, has explained that clinicians have a moral obligation and an obligation on their clients to consider their degree of discomfort when they approve clinical appointments (Thompson, 2019). Personification of an increased proportion of exhaustion in the working community has given rise to increasing concern, especially due to the obvious connection between decreased results, low attendance due to illness and job impairment. This is extremely harmful to suppliers of health care (infirmaries) which need uncompromising precision over the course of the job cycle. The effects of mistake in this field are as large as possible and are expected to extend the detrimental effects throughout people and institutions (Thompson, 2019).

  • Association between Job Stress and Number of Physical Symptoms among Female Nurses of Medical-university-affiliated Hospitals (Yoshioka et al., 2018).

 This research focuses on the study of 313 female nurses and assessing their health outcome with respect to their mental and physical health (Yoshiokaet al., 2018). All of these nurses are evaluated on the basis of their work schedule and work load. This gives a direct correlation with respect to the work load and the health of the medical healthcare providers (Yoshioka et al., 2018).

  • Association between 12-hr shifts and nursing resource use in an acute hospital: Longitudinal study (Griffiths et al., 2018).

This research gives ample reason for a re-examination of the transition to 12-hour work stress (Griffiths et al., 2018). Although it is quite proven that the revamped shift schedules may decrease cumulative service hours, indications that 12-hour changes are correlated with higher instances of medical care being interrupted or skipped increases the risk that clinicians may appear less effective, reducing the frequently reported efficiency improvements (Griffiths et al., 2018). In many scenarios, the average hours of service available to fulfil the patient's needs will need to be expanded in an attempt to correct the quality of healthcare (Griffiths et al., 2018).

References for Impact on Nurses Health and Quality of Services

Ball, J., Day, T., Murrells, T., Dall’Ora, C., Rafferty, A.M., Griffiths, P. and Maben, J., 2017. Cross-sectional examination of the association between shift length and hospital nurses job satisfaction and nurse reported quality measures. BMC nursing, 16(1), pp.1-7.

Caruso, C.C., Baldwin, C.M., Berger, A., Chasens, E.R., Landis, C., Redeker, N.S., Scott, L.D. and Trinkoff, A., 2017. Position statement: Reducing fatigue associated with sleep deficiency and work hours in nurses. Nursing Outlook, 65(6), pp.766-768.

Eriksen, M.B. and Frandsen, T.F., 2018. The impact of patient, intervention, comparison, outcome (PICO) as a search strategy tool on literature search quality: a systematic review. Journal of the Medical Library Association: JMLA, 106(4), p.420.

Fernandes JDC, Portela LF, Griep RH, Rotenberg L. Working hours and health in nurses of public hospitals according to gender. Rev Saude Publica. 2017 Jun 26;51:63. doi: 10.1590/S1518-8787.2017051006808. PMID: 28678910; PMCID: PMC5477706.

Griffiths P, Dall'Ora C, Sinden N, Jones J. Association between 12-hr shifts and nursing resource use in an acute hospital: Longitudinal study. J NursManag. 2019 Apr;27(3):502-508. doi: 10.1111/jonm.12704. Epub 2018 Nov 21. PMID: 30461112; PMCID: PMC7380133.

Manca, A., Cugusi, L., Dvir, Z. and Deriu, F., 2017. PubMed should raise the bar for journal inclusion. The Lancet, 390(10096), pp.734-735.

Rajan, D., 2017. Negative impacts of long working hours: A comparative study among nurses. MOJ App Bio Biomech, 1(2), pp.60-67.

Thompson BJ. Does work-induced fatigue accumulate across three compressed 12 hour shifts in hospital nurses and aides? PLoS One. 2019 Feb 7;14(2):e0211715. doi: 10.1371/journal.pone.0211715. PMID: 30730927; PMCID: PMC6366767.

Yoshioka N, Nomura K, Asayama K, Takenoshita S, Nagasawa T, Nakata Y, Hiraike H, Sasamori Y, Tsuchiya A, Ohkubo T, Okinaga H. [Association between Job Stress and Number of Physical Symptoms among Female Nurses of Medical-university-affiliated Hospitals]. Nihon EiseigakuZasshi. 2018;73(3):388-394. Japanese. doi: 10.1265/jjh.73.388. PMID: 30270307.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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