title: A comparison of the effects of fixed- and rotating-shift schedules on nursing staff attention levels: a randomized trial.
abstract: OBJECTIVE
  Sleep deficit affects neurobehavioral functioning, reduces attention and cognitive function, and negatively impacts occupational safety. This study investigated selective attention levels of nursing staff on different shifts.
  
  
  METHODS
  Using a prospective, randomized parallel group study, selective attention was measured using the d2 test in 62 nursing staff in a medical center in Taiwan.
  
  
  RESULTS
  There were significant differences in selective attention indicators (E%) between the fixed-day-shift group (control group) and rotating-shift group (experimental group): The percentage of errors (E%) for night-shift workers in the rotating-shift group was higher than that of fixed-day-shift workers, while the total number of items scanned minus error (TN - E) and concentration performance (CP) scores were higher for fixed-day-shift workers. Within the experimental group, the error rate on night shift was 0.44 times more than that on day shift and .62 times more than on evening shift; the TN-E on night shift was 38.99 items less than that on day shift, and the CP was 27.68 items less on night shift than on day shift; indicating that staff on the night shift demonstrated poorer speed and accuracy on the overall test than did the staff on day shifts.
  
  
  CONCLUSIONS
  Inadequate sleep and a state of somnolence adversely affected the attention and operation speed of work among night-shift workers. More than 2 days off is suggested when shifting from the night shift to other shifts to provide adequate time for circadian rhythms to adjust.
authors.affiliation: 1Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: Shu-Fen
authors.initials: SF
authors.lastname: Niu
authors.forename: Hsin
authors.initials: H
authors.lastname: Chu
authors.forename: Chiung-Hua
authors.initials: CH
authors.lastname: Chen
authors.forename: Min-Huey
authors.initials: MH
authors.lastname: Chung
authors.forename: Yu-Shiun
authors.initials: YS
authors.lastname: Chang
authors.forename: Yuan-Mei
authors.initials: YM
authors.lastname: Liao
authors.forename: Kuei-Ru
authors.initials: KR
authors.lastname: Chou
mesh_terms: D000328:Adult; D001288:Attention / Q000502:physiology*; D002940:Circadian Rhythm / Q000502:physiology; D003071:Cognition / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009741:Nursing Staff, Hospital; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology; D020178:Sleep Disorders, Circadian Rhythm / Q000503:physiopathology* / Q000523:psychology*; D013624:Taiwan; D014940:Work Schedule Tolerance / Q000502:physiology* / Q000523:psychology*; D055815:Young Adult