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document
[ Medical safety and staff mental health ] . Improvement in patient safety is a high-priority issue of great social import . Several studies have reported that most adverse events are due to errors of hospital staff , and emphasized the necessity of promoting countermeasures against medical errors . Root cause analysis ( RCA ) has been implemented to prevent such errors . However , the retrospective and qualitative nature of RCA is a limitation in scientific analyses examining causal relationships . We showed that prospective design path analysis using structural equation modeling ( SEM ) model for both direct and indirect effects enabled statistical exploration of root causes and estimation of their impact on the outcome . Our findings suggested such analysis to be useful in devising countermeasures against medical errors . The SEM model constructed in this study suggested that one of the potential root causes was sleep disturbance . We conducted a randomized crossover study whether or not brief bright light ( BL ) exposure on workday mornings can improve health , performance and safety in nurses with rapidly rotating shifts . Significant improvements were noted in the BL periods compared with the non-BL periods for self-assessed sleepiness at 10 : 00 on day-shift days , self-assessment of night sleep for day-shift days and for fatigue . Mean response time evaluated using the psychomotor vigilance task test ( PVT ) showed significant improvement in the BL periods compared with the non-BL periods . The frequency of perceived adverse events and near misses was also lower in the BL than in the non-BL periods , but not significantly so , possibly indicating that the one-month observation period was too short to achieve any significant success . Despite our study 's limitations , we have effectively demonstrated the potential for preventing medical error risk among night-shift workers .
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Intervention_Educational
structural equation modeling ( SEM )
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Intervention_Other
BL
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Outcome_Mental
sleep disturbance
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Outcome_Mental
self-assessed sleepiness
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Outcome_Mental
self-assessment of night sleep for day-shift days and for fatigue
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Outcome_Physical
Mean response time
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Outcome_Adverse-effects
frequency of perceived adverse events and near misses
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Participant_Condition
Medical safety
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Participant_Condition
nurses with rapidly rotating shifts
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Participant_Condition
night-shift workers