The Association between Working Hours with Vigilance and Executive Function of Intensive Care Unit Nurses

Abstract

Background. Vigilance and executive functions are integral to nursing practice. Prolonged working hours are associated with heightened fatigue and increased nursing errors. However, the impact of work duration on the vigilance and executive function of ICU nurses remains unexplored. Objective. This study aims to elucidate the association between ICU nurses’ working hours, vigilance, and executive function. Design. A cross-sectional study. Setting. Intensive care medicine department of a tertiary hospital in Zhengzhou, China. Participants. A total of 51 registered nurses who participated in 12 h shifts in the ICU completed the survey. Methods. E-prime software was employed to develop four test tasks to measure the vigilance and executive functioning of ICU nurses. The test was performed before the start of the shift and after 4, 8, and 12 h. Results. The analysis revealed no statistically significant differences in the response time of vigilance for ICU nurses across shifts ( $p=0.503$ ) or working hours ( $p=0.078$ ). However, a significant difference existed in lapses across working hours ( $p=0.005$ ), significantly increasing after 8 and 12 h. The analysis indicated a significant difference in Flanker effect size across different working hours ( $p=0.035$ ). The analysis revealed no significant differences in the switch cost ( $p=0.200$ ) or response accuracy ( $p=0.479$ ) of the task switching across working hours. The response accuracy for the 2-back task differed significantly ( $p=0.003$ ) across working hours. Conclusion. Limited evidence demonstrated that vigilance and specific aspects of executive functioning (inhibitory control and working memory) of ICU nurses were negatively correlated with the duration of their work in a real clinical setting. Furthermore, no vigilance and executive function differences were identified between day and night shifts. Implications for Nursing Management. Nursing administrators should reconsider scheduling 12 h shifts, shortening shifts, or implementing short rest periods to reduce fatigue and cognitive load. In addition, flexible scheduling and rationalizing the order of work may help reduce the possible risks associated with prolonged work.