UNIVERSITY OF SANTO TOMAS The Graduate School Research Methodology (RES_CAL) Thesis Proposal Conceptual Hypotheses: H1: Day shift nurses have a significant effect on the rate of medication errors. H2: Night shift nurses cause higher frequency of medication errors. H3: Graveyard shift nurses greatly increase the incidence of medication errors. H4: The amount of sleep affect directly day shift nurses. H5: The amount of sleep significantly influences night shift nurses. H6: The amount of sleep is affecting graveyard shift nurses. H7: The amount of sleep is inversely directed to the occurrence of medication errors. Theoretical Framework: The framework for this research is based Donabedian‟s Model of Quality Health Care, in which he categorized medical care in terms of structure, process, and outcome in order to determine indicators of quality (Aday, Begley, Lairson, & Balkrishnan, 2004; Donabedian, 1980).
In this study, structure shows two characteristics of nurses, namely, work shifts, and amount of sleep, contributing to his/her effectiveness in properly administering medications to a patient. Process is the administration of medications to patients in an inpatient setting by nurses. Finally, the primary outcome of interest is the occurrence of medication administration errors. Review of Literature to support hypotheses: H1: Day shift nurses have a significant effect on the rate of medication errors. The study of Abdalkader, R & Hayajneh, F. in 2008 revealed that the overall job performance was highest for nurses on day shift followed by the graveyard, then the night. But still, there was a clear effect in which the number of
UNIVERSITY OF SANTO TOMAS The Graduate School Research Methodology (RES_CAL) Thesis Proposal hours per week over 40 hours and the number of hours per day over 8 hours were positively associated with an increasing risk for injury. Errors were most frequent during the day shift, and 60% of the errors were attributed to nurses. H2: Night shift nurses cause higher frequency of medication errors. From Ellis, J (2008), while the work was the same, the risk of injury was 20% higher for those on the night shift than on the day shift. Working during the night is associated with more errors. Other studies have shown higher injury rates for those on night shifts. Nurses on night shifts have reported high levels of stress, physical exhaustion, and mental exhaustion (Dorrian, et al., 2006). A study of over 4,000 workers at an engineering firm that had workers on three shifts around the clock revealed that the incidence of accidents to workers increased on night and was highest on the graveyard shift. H3: Graveyard shift nurses greatly increase the incidence of medication errors. The results of Gold, D. et. al‟s study to graveyard nurses have demonstrated that sleep deprivation, leads to increased error rates on performance tasks (Gold, D., Rogacz, S., Bock, N., Tosteson, T., Baum, T., Speizer, F., et al.). According to Abdalkader, R & Hayajneh, F (2008), the problem...