Mobile App for Nurse Sleep and Fatigue
(RN-SLEEP Trial)

Overseen ByBeverly Hittle, PhD, RN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Cincinnati

Disqualifiers: Pregnancy, Child under 1, Sleep disorder

No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Healthy Habit, RN-SLEEP for nurse sleep and fatigue?

Research shows that nurses working long shifts often experience high levels of fatigue and poor sleep quality, which affects their alertness and performance. Treatments that improve sleep quality and reduce fatigue could help nurses feel more rested and alert during their shifts.¹ ² ³ ⁴ ⁵

Is the mobile app for nurse sleep and fatigue safe for humans?

The research articles do not provide specific safety data for the mobile app itself, but they highlight the importance of addressing sleep deprivation and fatigue in nurses, which can lead to errors and safety risks. This suggests that interventions targeting sleep and fatigue, like the app, could potentially improve safety by reducing these risks.¹ ² ⁶ ⁷ ⁸

How is the RN-SLEEP treatment different from other treatments for nurse sleep and fatigue?

The RN-SLEEP treatment is unique because it uses a mobile app to help nurses manage their sleep and fatigue, drawing on strategies from the airline industry's Fatigue Risk Management System (FRMS). This approach focuses on self-management and education, which is different from traditional methods that might not use technology or industry-specific strategies.¹ ² ³ ⁹ ¹⁰

What is the purpose of this trial?

The U.S. registered nurse (RN) workforce is the largest in the Healthcare and Social Assistance Sector and is at high risk for injuries and errors due to poor sleep and fatigue. Shift work (i.e., nights, evenings, rotating shifts) can contribute to RNs not obtaining adequate, restful sleep. Work intensity, including heavy physical and emotional workloads of caring for critically ill patients, can contribute to job stress, resulting in spill-over effects at home when RNs experience difficulties falling and staying asleep. To address work and home sleep barriers, this project proposes the development and pilot testing of RN-SLEEP, a skill-building mobile application designed to improve sleep. RN-SLEEP will provide a convenient, flexible space to learn sleep-enhancing evidence-based shift work-specific strategies, and cognitive-behavioral methods, (e.g., goal setting, relaxation training). Using NIOSH's Research 2 Practice (R2P) approach, the study team will collaborate with participants (N=18-24) from an RN union to refine RN-SLEEP content, integrating current sleep literature (including National Institute for Occupational Safety and Health \[NIOSH\] material) with cognitive-behavioral based training. RN-SLEEP will be pilot-tested using a two-group pretest-posttest study design, comparing sleep outcome measures (duration, quality) of RN-SLEEP participant users (n=38) with participants from an education control group (n=38). Data trends on fatigue, what drives behavior change (beliefs and self-efficacy), and other sleep outcome measures (timing, regularity, efficiency, daytime sleepiness) will be explored. RN-SLEEP goals align with Healthy People 2030, NIOSH's strategic goal to promote safe and healthy work design and well-being through two NIOSH Healthcare and Social Assistance Sector/Healthy Work Design Cross-Sector (HCSA/HWD) intermediate goals. HWD goal 7.2A is to conduct intervention research addressing fatigue (poor sleep sequela) due to suboptimal work designs (shift work) in the healthcare industry. HCSA/HWD goal 7.12A prioritizes interventions designed to impact work and non-work contributors to safety and health. This RN-SLEEP intervention aims to improve sleep by building skills that help RNs overcome obstacles to sleep from work and home, thus improving health and safety. Immediate outputs include a mobile app, designed and tested in collaboration with RNs, to improve sleep. Study results will be disseminated through our union collaborators, nursing conferences and journal publications, and our University's NIOSH-sponsored Education and Research Center social media outlets. Intermediate outcomes include enhancing RN sleep through training rarely available in nursing schools and traditional hospital health and safety training programs. Improving sleep can reduce fatigue and may decrease occupational injuries and errors. RN-SLEEP is adaptable, where future versions could be modified to meet the needs of other HCSA workers (i.e., nursing aides) and workers in other industries (e.g., oil and gas) scheduled to work non-standard work hours. End outcomes include integrating RN-SLEEP into a broader hospital organization intervention to mitigate fatigue risks.

Eligibility Criteria

This trial is for U.S. registered nurses who have been working night shifts for at least 6 months and have access to a smartphone. It aims to help them improve sleep and reduce fatigue through a mobile app.

Inclusion Criteria

You have worked the night shift for at least 6 months.

You possess a smart phone that is capable of connecting to the internet.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Content Refinement

Focus groups are conducted to refine the RN-SLEEP app content

4 weeks

Multiple focus group sessions

Intervention

Participants engage with the RN-SLEEP app or Healthy Habit app for sleep improvement

4 weeks

Daily app engagement

Follow-up

Participants are monitored for sleep quality and other outcomes post-intervention

8 weeks

Data collection at 4 and 8 weeks post-intervention

Treatment Details

Interventions

Healthy Habit
RN-SLEEP

Trial Overview The RN-SLEEP mobile application, which offers shift work-specific strategies and cognitive-behavioral methods like goal setting and relaxation training, is being tested against an educational control group.

Participant Groups

2Treatment groups

Experimental Treatment

Active Control

Group I: RN-SLEEPExperimental Treatment1 Intervention

Participants assigned to the RN-SLEEP group will access the training program via a mobile app for one month. The training app will include sleep physiology content, shift work strategies to promote sleep, cognitive behavior therapy for insomnia components, and skill-building techniques to support behavior modification.

Group II: Healthy HabitActive Control1 Intervention

Participants assigned to the Healthy Habit education control group will use a mobile app for one month focused on other healthy behaviors such as exercise tracking.