Differences in nutritional profile by chronotype among 12-h day shift and night shift nurses.

Acute care nurses may suffer substantial fatigue if working night shift or if assigned a shift contrasting their preferred sleep-wake patterns, called chronotype. Nurses are at higher risk for diet-related, metabolic diseases compared to other healthcare professionals. Yet, the impact of preferred chronotype and mismatch to assigned shift on nutritional intake and risk for metabolic disease among acute care nurses is unclear. This observational study analyzed dietary data from 52 acute care nurses. Participants completed the revised morningness-eveningness questionnaire which gives a total score between 4 and 26. Lower scores (<12) were flagged as evening type (E-type), higher scores (>17) defined as morning type (M-type), and scores between 12 and 17 were categorized as neither types (N-type). N-type participants were considered chronotype matched when assigned to either shift, whereas E-types were only considered matched if assigned to night shift, and M-types matched only if assigned to day shift. Participants also recorded all dietary intake for 7 d (reflecting a typical workweek) in the MyFitnessPal phone application. Findings indicated that eveningness nurses had markers of MetS, including a significantly larger body mass index and waist circumference than N-types (p < 0.05). E-types also consumed, on average, more calories than other chronotypes (m = 1833.7 kcal), although this was not a statistically significant finding. Mismatched day (n = 7, 13.4%) and night (n = 5, 9.6%) nurses in our sample consumed, on average, more calories (m = 1935.1 kcal, m = 1981.2 kcal, respectively) than matched day (n = 24, 46.2%, m = 1642.6 kcal) or night (n = 16, 30.8%, m = 1599.1 kcal) nurses, although this finding was not statistically significant. Mismatched day nurses consumed significantly less fiber than day matched nurses (median = 10.9 g versus median = 18.5 g, p = 0.04), while night mismatched consumed significantly more fiber compared to night matched (median = 21 g versus median = 12.2 g, p = 0.05) nurses. Participant diets overall did not follow recommendations by the United States Department of Agriculture (USDA), who consumed a higher percentage of calories from saturated fats and a smaller percentage of calories from fiber, habits which increase risk for metabolic syndrome. Further research surrounding nutritional pathways utilizing larger samples is needed to uncover relationships with metabolic syndrome especially for eveningness-type nurses or if working a shift mismatched with preferred chronotype.

High-Fidelity Simulation With Debriefing: Best Practice Education for Flight Nurses?

OBJECTIVE: High-fidelity simulation with debriefing has been shown to be effective in maintaining high-risk, low-volume proficiencies in nursing. The purpose of this evidence-based practice project was to implement high-fidelity simulation with debriefing to measure improvements in flight nurse skill acuity and retention when performing intubations. METHODS: This was a prospective evidence-based project conducted before and after a debriefing intervention that took place at HealthNet Aeromedical Services, Charleston, WV. Participants were flight nurses who were asked to intubate during a high-fidelity simulation session and participate in a debriefing session to reflect on their performance. They were then tested on 7-month skill retention. Eight subjects completed all stages of the study and were included in the analysis. RESULTS: The mean ± standard deviation time to successful intubation predebriefing was 26.9 ± 11.9 seconds; for postdebriefing, it was 24.8 ± 5.8 seconds. The mean ± standard deviation checklist score before debriefing was 7.9 ± 0.4 points, whereas for postdebriefing it was 9.4 ± 0.7 points. CONCLUSION: The implementation of debriefing after simulation improved the time to intubation and produced better clinical judgment and mastery while performing the intubation.

Commentary--Bridging the research and practice gap in autism: the importance of creating research partnerships with schools.

While the last 10 years have seen a significant increase in research published on early intervention and autism, there is a persistent disconnect between educational research and practice. Governments have invested significant funds in autism education, and a range of approaches have been implemented in schools, but there is limited research exploring whether these educational strategies are effective and a lack of involvement of teaching professionals in the research. Given that the majority of children and young people with autism spend most of their time in school and not in early or specialised intervention programmes, there is a compelling need to conduct better educational research and implement educational interventions in schools. We argue that building collaborative partnerships between researchers and school practitioners is central to achieving improved understanding of, and outcomes for, pupils on the autism spectrum. This commentary offers perspectives from teachers about their experiences of, and priorities for, research, and also presents a model of collaboration between autism school practitioners and researchers, which could support a more integrated approach to research. We reflect on the strengths and challenges of this as well as outcomes achieved so far.