For nurses working long night shifts, it is imperative that they have the ability to take naps to reduce fatigue, and that an appropriate environment is prepared where such naps can be taken. We verified the effects of 90 min napping on fatigue and the associated factors among nurses working 16-h night shifts. We investigated 196-night shifts among 49 nurses for one month. Wearable devices, data logging devices, and questionnaires were used to assess nap parameters, fatigue, and environmental factors such as the napping environment, ways of spending breaks, and working environment. Nurses who nap at least 90 min on most night shifts had more nursing experience. Multivariable logistic regression analysis showed that the environmental factors significantly associated with total nap duration (TND) ≥ 90 min were noise, time spent on electronic devices such as cellphones and tablets during breaks, and nap break duration. The night shifts with TND ≥ 90 min showed lower drowsiness after nap breaks and less fatigue at the end of night shift compared to those with TND < 90 min. Nurses and nursing managers should recognize the importance of napping and make adjustments to nap for at least 90 min during long night shifts.

Aim: To evaluate the effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults.Design: A systematic review based on the PRISMA guidelines.Methods: We searched for quantitative studies published between 2004–2020, using the PubMed, MEDLINE and CINAHL. The remaining 25 studies were appraised by the JBI tool.Results: Only four of the included studies were of high quality. Studies of above moderate quality demonstrated that disposable towels were as effective as cotton towels for skin lesions and bacterial removal. Applying a hot towel maintained the skin barrier function and provided warmth; cotton towels were effective for cleaning even with weak pressure, and post‐bed bath moisturizer treatment contributed to skin integrity.Conclusion: Although various methods have been examined, the available evidence is inadequate for establishing best practices. It is necessary to verify empirical research with rigorous methodology involving elderly inpatients and to develop instruments that measure patients' comfort.

Background: Dry skin is the most common skin problem, especially in the elderly. However, there is no effective instrument to assess dry skin in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the overall dry skin score (ODS‐J), the gold standard for dry skin assessment.Materials and methods: A cross‐sectional study was conducted on 47 patients aged > 65 years. Images of skin on their limbs were captured using a digital camera; both upper and lower limbs were assessed (n = 4/patient). One dermatologist; two wound, ostomy, and continence nurses; and three nursing researchers independently evaluated the images using the ODS‐J to assess the intraclass correlation coefficient (ICC) for inter‐rater reliability. Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) were the external criteria used to verify concurrent and known‐groups validity.Results: In total, 182 sites at which the SCH and TEWL could be measured were evaluated for the ODS‐J. The ICC for inter‐rater reliability of the six raters was 0.939 (p < 0.001). A higher ODS‐J was associated with lower SCH (ρ = −0.374; p < 0.001) and lower TEWL (ρ = −0.287; p < 0.001) values. The ODS‐J for the lower legs was significantly higher than that of the forearms (p < 0.001).Conclusions: The ODS‐J showed good inter‐rater reliability, concurrent validity, and known‐groups validity. It can be used by clinical nurses in Japan to observe patients’ skin and is an effective indicator for the evaluation of skin care.

Poor recovery from fatigue among shift-working nurses can cause a transition from acute to chronic fatigue. We aimed to clarify the relationship between nurses’ recovery from fatigue and sleep episodes after 16 h night shifts while considering age. This prospective study included 62 nurses who worked 16 h night shifts. Fatigue was assessed by a questionnaire before, during, and after the night shift, and the morning following the night shift. Sleep episodes were continuously measured using a wearable device. We performed a hierarchical cluster analysis of multivariate sleep parameters in first and main sleep episodes after night shifts. A linear mixed model was used to estimate the difference between clusters in recovery from fatigue after the night shift, considering age. The participants were classified into a high sleep quality group (HSQG) and low sleep quality group (LSQG) in sleep episodes after the night shift. There was a significant main effect of clusters, and HSQG was significantly more effective than LSQG in recovering from fatigue. However, no main effects of age or interaction were observed. The quality of first and main sleep episodes at home was associated with recovery from the night shift to the next day, regardless of age.