Research Article
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AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES

Year 2024, Volume: 33 Issue: 1, 106 - 113, 01.04.2024
https://doi.org/10.34108/eujhs.1325592

Abstract

It is predicted that due to the increasing work load of nurses, fatigue levels and knowledge transfer will be adversely affected. The present study aimed to determine the Fatigue Level, Handover Effectiveness, and Related Factors in Emergency Nurses. The study is a descriptive cross-sectional study. Research data were collected from nurses working in the emergency departments of 8 hospitals in a city in Turkiye. The data were collected through Google Form using the Personal Information Form, the Handover Evaluation Scale, and the Fatigue Scale. There is a negative and significant relationship between the nurses' fatigue levels and the handover effectiveness (r=-0.476 p<0.001). It was determined that there was a positive and meaningful relationship between the handover effectiveness and the handover duration and preparation time for the handover (in orderr=0.573 p<0.001, r=0.497 p<0.001). In addition, the nurses who were elderly, dissatisfied with working in the emergency department, only working during the day, caring for more patients, and having a longer total working time and weekly average working time in the emergency department were more tired and had lower handover effectiveness quality (p<0.05). It is possible to develop strategies to reduce fatigue levels and increase the quality of handover effectiveness by determining the fatigue of emergency nurses and these factors affecting the quality of handover effectiveness.

References

  • Yudiah W, Yudianto K, Prawesti A. Fatigue and work satisfaction of emergency nurses in Bandung, West Java, Indonesia. Belitung Nurs J. 2018;4(6):602-611. doi:10.33546/bnj.558
  • Clopton EL, Hyrkäs EK. Modeling emergency department nursing workload in real time: An exploratory study. Int Emerg Nurs. 2020; 48:100793. doi:10.1016/j.ienj.2019.100793
  • Wolf LA, Perhats C, Delao A, Martinovich Z. The effect of reported sleep, perceived fatigue, and sleepiness on cognitive performance in a sample of emergency nurses. J Nurs Admin. 2017; 47(1):41-49. doi:10.1097/NNA.0000000000000435
  • Sadeghniiat-Haghighi K, Yazdi Z. Fatigue management in the workplace. Ind Psychiatry J. 2015; 24(1):12-17. doi:10.4103/0972-6748.160915
  • Staggers N, Blaz JW. Research on nursing handoffs for medical and surgical settings: An integrative review. J Adv Nurs. 2013; 69:247-262. doi:10.11 11/j.1365-2648.2012.06087.x
  • Malekzadeh J, Mazluom SR, Etezadi T, Tasseri A. A standardized shift handover protocol: Improving nurses’ safe practice in intensive care unit. J Caring Sci. 2013; 2(3):177-185. doi:10.5681/jcs. 2013.022
  • Cohen M, Hilligoss P. The published literature on handoffs in hospitals: Deficiencies identified in an extensive review. Qual Saf Health Care. 2010; 19(6):493-497. doi:10.1136/qshc.2009.033480
  • Randell R, Wilson S, Woodward P. The importance of the verbal shift handover report: A multi-site case study. Int J Med Inform. 2011; 80(11):803-812. doi:10.1016/j.ijmedinf.2011.08.006
  • Fealy G, Donnelly S, Doyle G, et al. Clinical handover practices among healthcare practitioners in acute care services: A qualitative study. J Clin Nurs. 2019; 28(1-2):80-88. doi:10.1111/jocn.14643
  • Thomson H, Tourangeau A, Jeffs L, Puts M. Factors affecting quality of nurse shift handover in the emergency department. J Adv Nurs. 2018; 74(4):876-886. doi:10.1111/jan.13499
  • Birmingham P, Buffum MD, Blegen MA, Lyndon A. Handoffs and patient safety: Grasping the story and painting a full picture. West J Nurs Res. 2015; 37(11):1458-1478. doi:10.1177/0193945914539 052
  • Querstret D, O'Brien K, Skene DJ, Maben J. Improving fatigue risk management in healthcare: a scoping review of sleep-related/fatigue-management interventions for nurses and midwives (reprint). Int J Nurs Stud. 2020; 112:103745. doi:10.1016/j.ijnurstu.2020.103745
  • Moon T, Gonzales M, Woods A, Fox PE. Improving the quality of the operating room to intensive care unit handover at an urban teaching hospital through a bundled intervention. J Clin Anesth. 2016; 31:5-12. doi:10.1016/j.jclinane.2016.01.001
  • Kerr D, Lu S, McKinlay L, Fuller C. Examination of current handover practice: Evidence to support changing the ritual. Int J Nurs Pract. 2011; 17(4):342-350. doi:10.1111/j.1440-172X.2011.019 47.x
  • Funk E, Taicher B, Thompson J, Iannello K, Morgan B, Hawks S. Structured handover in the pediatric postanesthesia care unit. J Perianesth Nurs. 2016; 31(1):63-72. doi:10.1016/j.jopan.2014.07.015
  • Tuna R, Dalli B. The Turkish version of the handover evaluation scale: A validity and reliability study. Int J Nurs Pract. 2019; 25(6):e12787. doi:10.1111/ijn.12787
  • Labrague LJ. Pandemic fatigue and clinical nurses’ mental health, sleep quality and job contentment during the covid‐19 pandemic: The mediating role of resilience. J Nurs Manag. 2021; 29(7):1992-2001. doi:10.1111/jonm.13383
  • Cohen J. Statistical power analysis for the behavioral sciences. 2nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
  • Çelik S, Taşdemir N, Kurt A, İlgezdi E, Kubalas Ö. Fatigue in intensive care nurses and related factors. Int J Occup Environ Med. 2017; 8(4):199-206. doi:10.15171/ijoem.2017.1137
  • Ergin G, Yildirim Y. A validity and reliability study of the Turkish Checklist Individual Strength (CIS) questionnaire in musculoskeletal physical therapy patients. Physiother Theory Pract. 2012; 28(8):624-632. doi:10.3109/09593985.2011.654321
  • Yu F, Somerville D, King A. Exploring the impact of 12-hour shifts on nurse fatigue in intensive care units. Appl Nurs Res.2019; 50:151191. doi:10.1016/j.apnr.2019.151191.
  • Vanhaecht K, Seys D, Bruyneel L, et al. COVID-19 is having a destructive impact on health-care workers' mental well-being. Int J Qual Health Care. 2021; 33(1):mzaa158. doi:10.1093/intqhc/mza a158
  • AbuRuz E, Hayeah HM. Insomnia induced by night shift work is associated with anxiety, depression, and fatigue, among critical care nurses. Adv Stud Biol. 2017; 9(3):137-156. doi:10.12988/asb. 2017.738
  • Estryn-Béhar M, Van der Heijden BI. Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety. Work. 2012; 41(1):4283-4290. doi:10.32 33/WOR-2012-0724-4283
  • Steege LM, Rainbow JG. Fatigue in hospital nurses - “Supernurse” culture is a barrier to addressing problems: A qualitative interview study. Int J Nurs Stud. 2017; 67:20-28. doi:10.1016/j.ijnurstu. 2016.11.014
  • Dewanti NP, Jingga NA, Wahyudiono YDA. The relationship between work shifts and work environment with nurse fatigue in the emergency department. The Indonesian Journal of Occupational Safety and Health. 2022; 11(2):178-186. doi:10.20473/ijosh.v11i2.2022.178-186
  • Garosi E, Najafi S, Mazlouim A, Danesh MK, Abedi Z. Relationship between work ability index and fatigue among Iranian Critical Care Nurses. Int. J. Occup. Hyg. 2018; 10(3):135-142.
  • Şapulu Alakan Y, Akansel N. Investigation of studies related to fatigue in intensive care nurses. Hacettepe University Faculty of Health Sciences Journal.2021; 8(2):249-271. doi:10.21020/husbfd.80 4308
  • Chen J, Davis KG, Daraiseh NM, Pan W, Davis LS. Fatigue and recovery in 12-hour dayshift hospital nurses. J Nurs Manage. 2014; 22(5):593-603. doi:10.1111/jonm.12062
  • Krzemińska S, Guzik N, Borodzicz A, Bąk E, Arendarczyk M. Assessing fatigue among icu nurses using the yoshitake fatigue questionnaire-A pilot study. J Educ Health Sport. 2018; 8(6):103-112. doi:10.5281/zenodo.1252500
  • Maulina N, Syafitri L. Hubungan usia, lama bekerja dan durasi kerja dengan keluhan kelelahan mata pada penjahit sektor usaha ınformal di kecamatan banda sakti kota lhokseumawe tahun 2018.J Averrous. 2019; 5(2):44-58. doi:10.29103/averro us.v5i2.2080
  • Redley B, Botti M, Wood B, Bucknall T. Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australas Emerg Nurs J. 2017; 20(3):122-130. doi:10.1016/j.aenj.2017.05.003
  • Heryana A, Mahadewi EP, Buwana T. Studi beban kerja perawat IGD puskesmas kecamatan kalideres jakarta barat menggunakan metode work sampling. Indonesian Journal of Nursing Health Science. 2020; 5(2):86-93.
  • Doğan R, Bayraktar O.The relationship between mobbing and job performance in the private health sector: A research on nurses. Journal of Economics Business and Finance Research. 2020; 2(1):53-67. doi:10.38009/ekimad.691218
  • Sharma J, Dhar RL, Tyagi A. Stress as a mediator between work–family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence. Appl Nurs Res. 2016; 30:268-275. doi:10.1016/j.apnr.2015.01.010
  • Tuğrul E, Şahbaz M. Nurses’ practice and opinions about nursing handover. Journal of Adnan Menderes University Health Sciences Faculty.2021; 5(1):13-25. doi:10.46237/amusbfd.717408
  • Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud. 2018; 77:243-258. doi:10.1016/j.ijnurstu.2017.10.014
  • Welsh CA, Flanagan ME, Ebright P. Barriers and facilitators to nursing handoffs: Recommendations for redesign. Nurs Outlook. 2010; 58(3):148-154. doi:10.1016/j.outlook.2009.10.005
  • Toeima E, Morris E. Improving patients’ handover. Obstet Gynaecol Reprod Med. 2013; 23(7):221-223. doi:10.1016/j.ogrm.2013.04.003

ACİL SERVİS HEMŞİRELERİNİN YORGUNLUK DÜZEYİNİ VE DEVİR TESLİM ETKİNLİĞİNİ ETKİLEYEN FAKTÖRLER ÜZERİNE BİR DEĞERLENDİRME

Year 2024, Volume: 33 Issue: 1, 106 - 113, 01.04.2024
https://doi.org/10.34108/eujhs.1325592

Abstract

Hemşirelerin artan iş yükü nedeniyle yorgunluk düzeylerinin ve bilgi aktarımının olumsuz etkileneceği öngörülmektedir. Bu çalışmada acil hemşirelerinde yorgunluk düzeyi, devir teslim etkinliği ve ilişkili faktörlerin belirlenmesi amaçlanmıştır. Çalışma tanımlayıcı türde kesitsel bir çalışmadır. Araştırma verileri Türkiye'de bir ilde bulunan 8 hastanenin acil servislerinde çalışan hemşirelerden toplanmıştır. Veriler Kişisel Bilgi Formu, Devir Teslim Değerlendirme Ölçeği ve Yorgunluk Ölçeği kullanılarak Google Form aracılığıyla toplanmıştır. Hemşirelerinin yorgunluk seviyeleri ile nöbet devir teslim etkinliği arasında negatif yönlü anlamlı bir ilişki vardır (r=-0.476p<0.001). Nöbet devir teslimine hazırlık süresi ve nöbet devir teslim süresi ile nöbet devir teslim etkinliği arasında ise pozitif yönlü anlamlı bir ilişki olduğu belirlenmiştir (sırasıyla r=0.573p<0.001, r=0.497 p<0.001). Ayrıca ileri yaşta olan, acil serviste çalışmaktan memnun olmayan, sürekli gündüz çalışan, daha fazla hastaya bakım veren, acil serviste toplam çalışma süresi ve haftalık ortalama çalışma süresi fazla olan hemşirelerin daha yorgun olduğu ve nöbet devir teslim kalitesinin daha düşük olduğu saptanmıştır (p<0.05). Acil servis hemşirelerinin yorgunluğunu ve nöbet devir teslim etkinlik kalitesini etkileyen bu faktörleri saptayarak, yorgunluk seviyelerini azaltmayı ve nöbet devir teslim etkinliği kalitesini artırmayı amaçlayan stratejiler geliştirmek mümkündür.

References

  • Yudiah W, Yudianto K, Prawesti A. Fatigue and work satisfaction of emergency nurses in Bandung, West Java, Indonesia. Belitung Nurs J. 2018;4(6):602-611. doi:10.33546/bnj.558
  • Clopton EL, Hyrkäs EK. Modeling emergency department nursing workload in real time: An exploratory study. Int Emerg Nurs. 2020; 48:100793. doi:10.1016/j.ienj.2019.100793
  • Wolf LA, Perhats C, Delao A, Martinovich Z. The effect of reported sleep, perceived fatigue, and sleepiness on cognitive performance in a sample of emergency nurses. J Nurs Admin. 2017; 47(1):41-49. doi:10.1097/NNA.0000000000000435
  • Sadeghniiat-Haghighi K, Yazdi Z. Fatigue management in the workplace. Ind Psychiatry J. 2015; 24(1):12-17. doi:10.4103/0972-6748.160915
  • Staggers N, Blaz JW. Research on nursing handoffs for medical and surgical settings: An integrative review. J Adv Nurs. 2013; 69:247-262. doi:10.11 11/j.1365-2648.2012.06087.x
  • Malekzadeh J, Mazluom SR, Etezadi T, Tasseri A. A standardized shift handover protocol: Improving nurses’ safe practice in intensive care unit. J Caring Sci. 2013; 2(3):177-185. doi:10.5681/jcs. 2013.022
  • Cohen M, Hilligoss P. The published literature on handoffs in hospitals: Deficiencies identified in an extensive review. Qual Saf Health Care. 2010; 19(6):493-497. doi:10.1136/qshc.2009.033480
  • Randell R, Wilson S, Woodward P. The importance of the verbal shift handover report: A multi-site case study. Int J Med Inform. 2011; 80(11):803-812. doi:10.1016/j.ijmedinf.2011.08.006
  • Fealy G, Donnelly S, Doyle G, et al. Clinical handover practices among healthcare practitioners in acute care services: A qualitative study. J Clin Nurs. 2019; 28(1-2):80-88. doi:10.1111/jocn.14643
  • Thomson H, Tourangeau A, Jeffs L, Puts M. Factors affecting quality of nurse shift handover in the emergency department. J Adv Nurs. 2018; 74(4):876-886. doi:10.1111/jan.13499
  • Birmingham P, Buffum MD, Blegen MA, Lyndon A. Handoffs and patient safety: Grasping the story and painting a full picture. West J Nurs Res. 2015; 37(11):1458-1478. doi:10.1177/0193945914539 052
  • Querstret D, O'Brien K, Skene DJ, Maben J. Improving fatigue risk management in healthcare: a scoping review of sleep-related/fatigue-management interventions for nurses and midwives (reprint). Int J Nurs Stud. 2020; 112:103745. doi:10.1016/j.ijnurstu.2020.103745
  • Moon T, Gonzales M, Woods A, Fox PE. Improving the quality of the operating room to intensive care unit handover at an urban teaching hospital through a bundled intervention. J Clin Anesth. 2016; 31:5-12. doi:10.1016/j.jclinane.2016.01.001
  • Kerr D, Lu S, McKinlay L, Fuller C. Examination of current handover practice: Evidence to support changing the ritual. Int J Nurs Pract. 2011; 17(4):342-350. doi:10.1111/j.1440-172X.2011.019 47.x
  • Funk E, Taicher B, Thompson J, Iannello K, Morgan B, Hawks S. Structured handover in the pediatric postanesthesia care unit. J Perianesth Nurs. 2016; 31(1):63-72. doi:10.1016/j.jopan.2014.07.015
  • Tuna R, Dalli B. The Turkish version of the handover evaluation scale: A validity and reliability study. Int J Nurs Pract. 2019; 25(6):e12787. doi:10.1111/ijn.12787
  • Labrague LJ. Pandemic fatigue and clinical nurses’ mental health, sleep quality and job contentment during the covid‐19 pandemic: The mediating role of resilience. J Nurs Manag. 2021; 29(7):1992-2001. doi:10.1111/jonm.13383
  • Cohen J. Statistical power analysis for the behavioral sciences. 2nd edn. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
  • Çelik S, Taşdemir N, Kurt A, İlgezdi E, Kubalas Ö. Fatigue in intensive care nurses and related factors. Int J Occup Environ Med. 2017; 8(4):199-206. doi:10.15171/ijoem.2017.1137
  • Ergin G, Yildirim Y. A validity and reliability study of the Turkish Checklist Individual Strength (CIS) questionnaire in musculoskeletal physical therapy patients. Physiother Theory Pract. 2012; 28(8):624-632. doi:10.3109/09593985.2011.654321
  • Yu F, Somerville D, King A. Exploring the impact of 12-hour shifts on nurse fatigue in intensive care units. Appl Nurs Res.2019; 50:151191. doi:10.1016/j.apnr.2019.151191.
  • Vanhaecht K, Seys D, Bruyneel L, et al. COVID-19 is having a destructive impact on health-care workers' mental well-being. Int J Qual Health Care. 2021; 33(1):mzaa158. doi:10.1093/intqhc/mza a158
  • AbuRuz E, Hayeah HM. Insomnia induced by night shift work is associated with anxiety, depression, and fatigue, among critical care nurses. Adv Stud Biol. 2017; 9(3):137-156. doi:10.12988/asb. 2017.738
  • Estryn-Béhar M, Van der Heijden BI. Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety. Work. 2012; 41(1):4283-4290. doi:10.32 33/WOR-2012-0724-4283
  • Steege LM, Rainbow JG. Fatigue in hospital nurses - “Supernurse” culture is a barrier to addressing problems: A qualitative interview study. Int J Nurs Stud. 2017; 67:20-28. doi:10.1016/j.ijnurstu. 2016.11.014
  • Dewanti NP, Jingga NA, Wahyudiono YDA. The relationship between work shifts and work environment with nurse fatigue in the emergency department. The Indonesian Journal of Occupational Safety and Health. 2022; 11(2):178-186. doi:10.20473/ijosh.v11i2.2022.178-186
  • Garosi E, Najafi S, Mazlouim A, Danesh MK, Abedi Z. Relationship between work ability index and fatigue among Iranian Critical Care Nurses. Int. J. Occup. Hyg. 2018; 10(3):135-142.
  • Şapulu Alakan Y, Akansel N. Investigation of studies related to fatigue in intensive care nurses. Hacettepe University Faculty of Health Sciences Journal.2021; 8(2):249-271. doi:10.21020/husbfd.80 4308
  • Chen J, Davis KG, Daraiseh NM, Pan W, Davis LS. Fatigue and recovery in 12-hour dayshift hospital nurses. J Nurs Manage. 2014; 22(5):593-603. doi:10.1111/jonm.12062
  • Krzemińska S, Guzik N, Borodzicz A, Bąk E, Arendarczyk M. Assessing fatigue among icu nurses using the yoshitake fatigue questionnaire-A pilot study. J Educ Health Sport. 2018; 8(6):103-112. doi:10.5281/zenodo.1252500
  • Maulina N, Syafitri L. Hubungan usia, lama bekerja dan durasi kerja dengan keluhan kelelahan mata pada penjahit sektor usaha ınformal di kecamatan banda sakti kota lhokseumawe tahun 2018.J Averrous. 2019; 5(2):44-58. doi:10.29103/averro us.v5i2.2080
  • Redley B, Botti M, Wood B, Bucknall T. Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australas Emerg Nurs J. 2017; 20(3):122-130. doi:10.1016/j.aenj.2017.05.003
  • Heryana A, Mahadewi EP, Buwana T. Studi beban kerja perawat IGD puskesmas kecamatan kalideres jakarta barat menggunakan metode work sampling. Indonesian Journal of Nursing Health Science. 2020; 5(2):86-93.
  • Doğan R, Bayraktar O.The relationship between mobbing and job performance in the private health sector: A research on nurses. Journal of Economics Business and Finance Research. 2020; 2(1):53-67. doi:10.38009/ekimad.691218
  • Sharma J, Dhar RL, Tyagi A. Stress as a mediator between work–family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence. Appl Nurs Res. 2016; 30:268-275. doi:10.1016/j.apnr.2015.01.010
  • Tuğrul E, Şahbaz M. Nurses’ practice and opinions about nursing handover. Journal of Adnan Menderes University Health Sciences Faculty.2021; 5(1):13-25. doi:10.46237/amusbfd.717408
  • Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud. 2018; 77:243-258. doi:10.1016/j.ijnurstu.2017.10.014
  • Welsh CA, Flanagan ME, Ebright P. Barriers and facilitators to nursing handoffs: Recommendations for redesign. Nurs Outlook. 2010; 58(3):148-154. doi:10.1016/j.outlook.2009.10.005
  • Toeima E, Morris E. Improving patients’ handover. Obstet Gynaecol Reprod Med. 2013; 23(7):221-223. doi:10.1016/j.ogrm.2013.04.003
There are 39 citations in total.

Details

Primary Language English
Subjects Emergency Nursing, Fundamentals of Nursing
Journal Section Research Article
Authors

Ali Kaplan 0000-0001-8242-0110

Early Pub Date April 2, 2024
Publication Date April 1, 2024
Submission Date July 10, 2023
Published in Issue Year 2024 Volume: 33 Issue: 1

Cite

APA Kaplan, A. (2024). AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES. Sağlık Bilimleri Dergisi, 33(1), 106-113. https://doi.org/10.34108/eujhs.1325592
AMA Kaplan A. AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES. JHS. April 2024;33(1):106-113. doi:10.34108/eujhs.1325592
Chicago Kaplan, Ali. “AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES”. Sağlık Bilimleri Dergisi 33, no. 1 (April 2024): 106-13. https://doi.org/10.34108/eujhs.1325592.
EndNote Kaplan A (April 1, 2024) AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES. Sağlık Bilimleri Dergisi 33 1 106–113.
IEEE A. Kaplan, “AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES”, JHS, vol. 33, no. 1, pp. 106–113, 2024, doi: 10.34108/eujhs.1325592.
ISNAD Kaplan, Ali. “AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES”. Sağlık Bilimleri Dergisi 33/1 (April 2024), 106-113. https://doi.org/10.34108/eujhs.1325592.
JAMA Kaplan A. AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES. JHS. 2024;33:106–113.
MLA Kaplan, Ali. “AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES”. Sağlık Bilimleri Dergisi, vol. 33, no. 1, 2024, pp. 106-13, doi:10.34108/eujhs.1325592.
Vancouver Kaplan A. AN EVALUATION ON THE FACTORS AFFECTING THE LEVEL OF FATIGUE AND HANDOVER EFFECTIVENESS OF EMERGENCY DEPARTMENT NURSES. JHS. 2024;33(1):106-13.