NURS 668 Week 5 Capstone Paper: Education Program Example

Rest for the Night Shift: A Four-Week Sleep Health Education Program for Medical-Surgical Night Nurses

Purpose and Link to the Literature Review

Four findings from the capstone's literature review shape this program. Most night nurses sleep badly, and their short sleep travels with fatigue, low mood, slower thinking and more self-reported medication mistakes. Trials show that teaching sleep skills over several weeks, especially with mindfulness practice, makes a measurable difference (Deng et al., 2026; Lee & Tse, 2026). Three things at home, bright light before bed, irregular noise during sleep and too little exercise, can be changed by the nurse (Li et al., 2026; Weng et al., 2026; Zydziunaite, 2026). And Christian writers on nursing describe the need for rest as a limit God built into people on purpose (Templeton & Kapic, 2026). The purpose of Rest for the Night Shift is to translate those findings into a four-week education program that improves sleep quality among the night nurses on a 36-bed medical-surgical unit.

Audience and Needs Assessment

The program is designed for the unit's 31 registered nurses and 9 patient care technicians who work at least two night shifts a week. A five-question sleep survey completed by 27 night staff in the month before the program found that 19 slept less than six hours after a typical night shift, 14 drove home in daylight without sunglasses, 22 used a phone in bed before sleeping, and 6 regularly took a sleep aid. Those figures fit the published pattern in which most night nurses sleep poorly and a smaller group already relies on medication (Chu et al., 2026). The survey also showed that 3 a.m. to 4 a.m., during the unit's quietest hour, was the only time most staff could attend a session, which shaped the schedule below.

Learning Objectives

By the end of the four-week program, participants will be able to:

• Explain how night work disrupts the circadian sleep-wake cycle and why daytime sleep is shorter and lighter
• Identify at least three personal sources of light, noise or activity patterns that affect their daytime sleep
• Create a written sleep protection plan for the day after a night shift
• Practice a five-minute mindfulness or breathing exercise on at least four days a week for three weeks
• Describe the referral pathway for persistent insomnia or regular sleep aid use

Each objective names something a nurse will do or produce, so the evaluation can check whether it happened rather than whether the class was enjoyed.

Theoretical Basis

Two frameworks guide the program. Adult learning principles hold that adults learn best when content solves a problem they recognize, draws on their experience and can be applied at once; night nurses already know they sleep badly, so the program starts from their experience rather than from physiology alone. The circadian framework described in the literature review explains the content: because the internal clock is set mainly by light, behaviors that reduce light before sleep and support darkness, quiet and calm during daytime sleep should narrow the gap between the body's signals and the nurse's schedule. Placing both frameworks together keeps the program practical without losing its scientific basis.

Program Content and Schedule

The opening session covers the content the review supports most strongly. It explains why the drive home in morning light delays sleep, using the finding that personal light exposure before sleep was the strongest predictor of shorter sleep among shift nurses (Li et al., 2026). It explains why steady background sound is better than silence broken by traffic, because fluctuating noise was associated with restless sleep even without full waking (Weng et al., 2026). It encourages physical activity on days off while being honest that its effect on sleep is modest (Zydziunaite, 2026). Each participant leaves with a draft sleep protection plan, a pair of wraparound sunglasses and access to the mindfulness audio.

The three weeks of practice reflect the design of the trials that changed sleep. Both meta-analyses drew on interventions that asked nurses to practice skills over several weeks, and mindfulness training ranked highest for improving sleep duration in the network meta-analysis (Deng et al., 2026). The sleep diary gives each nurse data about their own patterns and gives the program data for evaluation.

Teaching Strategies

The session uses short teaching segments of no more than ten minutes, a discussion of participants' own post-shift routines, a demonstration of blackout and light-blocking options, and a guided breathing exercise practiced together. Materials are written at an eighth-grade reading level and available on the unit's intranet page. Peer champions, two experienced night nurses who complete the program first, lead the huddle check-ins, because peer and family support appear in the research as part of what helps night nurses sleep (Gu et al., 2026).

Christian Worldview Component

Week 3 includes an optional 20-minute reflection led by the hospital chaplain, drawing on the argument that human limits are part of God's good design and that failing to honor them contributes to burnout (Templeton & Kapic, 2026). The reflection uses Jesus' invitation to His disciples to come away and rest a while (English Standard Version Bible, 2001/2016, Mark 6:31) and invites participants to consider rest as stewardship. Because surveys of nurses have linked daily spiritual experience with lower burnout (Denke et al., 2026), the reflection may support well-being for those who choose it, but it is optional so that no participant feels pressured.

Resources and Budget

The program requires session time, materials and a small amount of equipment. The main costs are 45 minutes of paid time for each of 40 staff, about $1,100, two peer champions' preparation time, about $300, wraparound sunglasses for each participant, about $400, and printing, about $100, for a total near $1,900. The mindfulness audio uses a free, publicly available recording, and the chaplain's time is provided by the hospital. No new equipment is needed for the unit itself.

Implementation Plan and Barriers

The program will be introduced in three steps. In the month before launch, the unit manager will announce the program at the staff meeting and on the night huddle board, and the two peer champions will complete it themselves so they can speak from experience. The opening session will then run on four consecutive nights at 3 a.m., so that every night nurse can attend during a regular shift without coming in on a day off. Coverage during the session will come from the charge nurse and the resource nurse, who will take call lights for the 45 minutes. Finally, the practice weeks will run alongside normal work, with the champions checking in at huddles.

Three barriers are likely. First, a busy night may cancel a session, so each night's session can be moved to the following night without losing the sequence. Second, some nurses may see sleep as a private matter and resist discussing it at work; the session will emphasize that no one is asked to share personal details and that the sleep diary is kept by the nurse, not collected. Third, nurses who work nights only occasionally may find the content less relevant, so the materials will include a short section on switching between day and night schedules.

Sustainability

If the evaluation shows benefit, the opening session will become part of orientation for every nurse hired to nights, the mindfulness audio and sleep plan template will stay on the unit's intranet page, and the peer champions will repeat the four-week program twice a year for new staff. The unit's practice council will review the 12-week results and decide whether to recommend the program to other night units in the hospital.

Evaluation

Evaluation measures learning, behavior and outcomes. Sleep quality is measured with the Pittsburgh Sleep Quality Index before the program, at the end of week 4 and at 12 weeks, the instrument used across the studies reviewed (Chu et al., 2026; Gu et al., 2026). A ten-item knowledge test is given before and after the opening session. Behavior is measured through sleep diaries and a count of mindfulness practice days. Each participant's sleep protection plan is reviewed at the closing huddle. Participant feedback is collected with a short anonymous survey. The program will be considered successful if the mean index score falls by at least two points at 12 weeks, if 80% of participants complete a sleep plan, and if at least half practice mindfulness on four or more days a week. Because poor sleep and fatigue have been linked to medication errors (Kang et al., 2026), the unit will also review its night-shift medication error reports for the quarter before and after the program, recognizing that such reports are too few to show a clear effect.

Conclusion

Rest for the Night Shift turns the literature review's conclusions into a practical, four-week program built around how night nurses actually live: a short session at the quietest hour, practice at home, peer support, an optional reflection on rest and a measured evaluation. It cannot remove the cost of night work, but it gives nurses evidence-based skills to protect the sleep they get.

References

Chu, X., Lv, J., Li, G., & Wang, D. (2026). Latent profile analysis of sleep quality and associated factors on sleep patterns in night-shift nurses: A cross-sectional study. Frontiers in Public Health, 14, Article 1800662. https://doi.org/10.3389/fpubh.2026.1800662

Deng, G., Zeng, L., Wang, F., Hou, H., Liu, L., An, Y., Lv, Y., & Hu, X. (2026). Non-pharmacological therapies for sleep and occupational stress regulation among nightshift nurses: A systematic review and Bayesian network meta-analysis based on randomized controlled trials. Frontiers in Public Health, 14, Article 1882224. https://doi.org/10.3389/fpubh.2026.1882224

Denke, L., Atem, F. D., & Rubin, M. A. (2026). Can spirituality help burnout in nurses? A correlational study. Journal of Christian Nursing, 43(3), 166-173. https://doi.org/10.1097/CNJ.0000000000001375

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Gu, Y., Huang, Q., Ni, S., Dai, C., & Ren, W. (2026). Associations between fatigue and sleep among night-shift nurses: Mediating role of depressive symptoms and social support. Journal of Nursing Management, 2026(1), Article e5828649. https://doi.org/10.1155/jonm/5828649

Kang, Y., Choi, E. Y., Baek, W., Park, C., & Min, A. (2026). Associations of insomnia, fatigue, and overtime work with self-reported medication errors among perianesthesia nurses: A cross-sectional study. International Nursing Review, 73(3), Article e70233. https://doi.org/10.1111/inr.70233

Lee, A. Y. L., & Tse, L. A. (2026). Non-pharmacological intervention for shift nurses' sleep: Systematic review and meta-analysis. Occupational Medicine. Advance online publication. https://doi.org/10.1093/occmed/kqag085

Li, B., Liu, Y., Li, W., Ma, J. Y. T., Huss, A., Chan, J., Wing, Y. K., & Tse, L. A. (2026). Principal component analysis of pre-sleep artificial light at night exposure patterns and the associations with sleep disturbances in Hong Kong shift-working nurses and daytime office workers. Occupational and Environmental Medicine. Advance online publication. https://doi.org/10.1136/oemed-2026-111078

Templeton, S. J., & Kapic, K. M. (2026). The importance of understanding limitations in nursing. Journal of Christian Nursing, 43(4), 224-229. https://doi.org/10.1097/CNJ.0000000000001411

Weng, X., Tang, N. H. Y., Ma, J. Y. T., Wan, C. C. M., Liu, Y., Wang, F., Li, B., Liao, G., Li, W., Ho, A. W., Ho, C. S., Arrandale, V. H., & Tse, L. A. (2026). Association of real-time noise exposure with rest-activity circadian rhythms and sleep health: A 7-day longitudinal measure among Hong Kong nurses with night-shifts. Environmental Pollution, 406, Article 128644. https://doi.org/10.1016/j.envpol.2026.128644

Zydziunaite, V. (2026). Sleep quality and physical activity of night shift nurses working at hospitals: A cross-sectional survey study. Nursing Reports, 16(7), Article 223. https://doi.org/10.3390/nursrep16070223