Work Around the Clock
Introduction Work Around the Clock (WAC) is a multicenter prevention project that involves the participation of 3 partner hospitals: EOC, KSGR and RHNe and expects to reach a total number of approximately 800 shift-working nurses. The prevention project is aimed at shift-working nurses with the goal of improving their quality of life and mental health through targeted interventions promoting healthy sleep and preventing sleep disorders, particularly Shift Work Sleep Disorder (SWSD). It is a substantial improvement, an expansion of the basic prevention package available to them right now i.e. the yearly mandatory live visits with a sleep physician.
SWSD is a circadian rhythm sleep disorder defined by insomnia or excessive sleepiness caused by a work schedule overlapping the usual sleep period. It's common among shift workers. About one in four shift workers develops this sleep disorder.
Project components
There are three levels to our prevention:
- Primary prevention
- Webinar: an online training course for all shift-working nurses consisting of 5-6 short videos (ca. 30-40 minutes in total). Topics learned include but are not limited to: sleep physiology and chronobiology, sleep disorders, shift-work and sleep, sleep hygiene techniques.
- Cronopoli: also aimed at all shift-working nurses, it is a gamified digital application in which departments of the same hospital "compete" against each other. Participants are presented with fictional shift work scenarios and must decide which sleep hygiene strategies to adopt.
- Secondary prevention. Cognitive Behavioral Therapy for Insomnia (CBTi), for EOC and KSGR only: it is not aimed at all shift-working nurses, but only for those who are found to have symptoms during separate mandatory in-person visits at the hospital or will apply for it voluntarily. The shift worker/patient will then have regular meetings with psychotherapists and will be assigned tasks to complete between sessions on Moodle.
- Tertiary prevention. Timely management and recovery from unfitness for duty, for EOC and KSGR only. Nurses with suspected Shift Work Sleep Disorder (SWSD) are temporarily exempt from night duties and referred to partner hospitals for sleep medicine evaluations. These diagnostic tests and consultations are fully covered by Swiss health insurance (LaMAL). The main objective of this tertiary prevention initiative is to treat the nurses and safely restore their fitness for night shifts. Ultimately, the occupational physician decides on their return to work, aiming to protect staff health and retain vulnerable employees in the profession.