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I worked night shift for two years. At one hospital I worked at we barely got a break, and at the other one we actually had a one-hour break, where a break nurse was actually there to take on our patient assignment during the break. To add, there was a Zen room that was in place for nurses who want to go during their break, and many nurses would actually nap. I myself wasn’t ever able to actually fall asleep, but I often wondered if the nurses who chose to take a nap during this break were more tired, or more energized. The study that you found that actually found that napping can actually disrupt circadian rhythms and interfere with work, as well as increase fatigue was definitely an interesting finding. I found another cross-sectional study that was conducted on this topic of napping during the night shift. The study actually states how in Brazil, there is a law that nurses are able to take three hours during the shift to sleep (Silva-Costa et al, 2015). The results found that the naps during these shifts actually did reduce tiredness as well as fatigue (Silva-Costa, 2015). This would be interesting to see if this was because of the length of the nap as well, in comparison to the results of the study that you found.


Silva-Costa, A., Rotenberg, L., Griep, R. H., & Fischer, F. M. (2015). Napping on the night shift among nursing staff: Potential benefits for workers’ health. Escola Anna Nery – Revista de Enfermagem, 19(1).


As you have identified semi-experimental design would best fit your research question. A design such as the one who have chosen has a cause and effect relationship, which as you have stated studies can be evaluated between the intervention and outcome. Healthcare associated infections are one of the most challenges in health care today. Hand hygiene compliance has been the most effective preventative measure in reduction of hospital acquired infections. Farhoudi et. al, (2016) conducted a study of the implementation of the World Health Organization and the implementation of hand hygiene improvement program, the study concluded that the rate of infection declined from 4.8 to 3.3 per 1000 participants (p.4). The use of semi experimental designs has been used to link the decrease rate of hospital acquired infections as a cause and effect in education in patients and nursing education. Such as the study conducted by Manresa et. al, (2020) and improving patients hand hygiene which demonstrated that the success in patient and staff education and hand hygiene. I agree that utilizing a semi-experimental design is most appropriate to demonstrate suitable outcomes in hand hygiene compliance.


Farhoudi, F., Sanaei Dashti, A., Hoshangi Davani, M., Ghalebi, N., Sajadi, G., & Taghizadeh, R. (2016). Impact of WHO Hand Hygiene Improvement Program Implementation: A Quasi-Experimental Trial. BioMed Research International, 2016, 1–7. https://doi:10.1155/2016/7026169Links to an external site.

Manresa, Y., Abbo, L., Sposato, K., de Pascale, D., & Jimenez, A. (2020). Improving patients’ hand hygiene in the acute care setting: Is staff education enough? American Journal of Infection Control, 48(9), 1100–1101. https://doi/10.1016/j.ajic.2019.12.007


Inappropriate Use of Emergency Rooms Research Design

There is an increase in the use of emergency rooms (ER) for primary care services as well as services for care deemed inappropriate for the ER. Most of these patients seen have multiple chronic conditions and other factors contributing to the overall increase in visits. The research question is as follows: does unnecessary emergency room visits have negative effects on patient care outcomes, financial consequences and nurses’ care within hospitals primarily caring for adults?

The objective of this study to examine the association between unnecessary emergency room visits and the effects on patient care outcomes, financial ramifications, and nurses’ delivery of care in adult based hospitals. This study seeks to identify a relationship between these variables. Within the nonexperimental quantitative research design category, a correlational approach seems appropriate. According to Seeram (2019), correlational research investigates the interaction between two or more variables to examine the relationship. The influx in emergency room visits will influence patient care outcomes, finances, and nurses’ work. In this case, the emergency room visit will not be manipulated as manipulation of variables is a basis for experimental studies. The researcher is not an active mediator but rather a passive observer examining the association. In a study by Perez et al. (2018), the authors performed a retrospective study (a subset of a correlational design) to observe the adequacy of ER visits and pregnant women. Their data analysis revealed 14.4% of visits were inadequate. Data also revealed ER visits could have been reduced by 61% with various interventions. This reduction could decrease health costs at large overall negatively effecting health finances.


Seeram, E. (2019). An overview of correlational research. Radiologic Technology, 91(2), 176-179.

Perez, E. F., Auge, N. K., Gonzalez, J. G., Pust, A. B., Panades, A. P., & Collado, R. C. (2018). Inadequate visits to the emergency department by pregnant women. Journal of Obstetrics and Gynaecology, 38(2), 161-166. https://doi.org/10.1080/01443615.2017.1328672

(No DOI available for Seeram article)