RESUMEN
Objective Different factors, such as medication use and shift work, can influence sleep quality. We aimed to determine the association between medication use and sleep quality in shift workers versus daytime workers. Materials and Methods We conducted a quantitative cross-sectional study with a convenience sample of active workers. Online questionnaires were applied to assess sleep quality, sleepiness, medication use, and sociodemographic characteristics. Results A total of 296 participants were included: 124 (41.89%) daytime workers and 172 (58.11%) shift workers. In total, 130 (43.92%) participants worked in the healthcare sector, 116 (39.19%), in industry, and 50 (16.89%), in other sectors. After a bivariate analysis, poor sleep quality was associated with the presence of sleep disorders ( p < 0.001), type of work (shift or day work) ( p < 0.001), and the use of sleeping medication ( p < 0.001). Although shift workers had worse sleep quality, no differences were found regarding the use of medications that act directly on the central nervous system or with proven effects on sleep. No association was found between medication use and sleep quality. When adjusted for the different variables that were individually associated with poor sleep quality, through a logistic regression model, none showed an increased risk of poor sleep quality. Discussion In spite of the need for further research, our results have shown that sleep quality is influenced by many different factors whose impact must be evaluated in combination, and not just in a bivariate manner. There are many factors individually associated with poor sleep quality, but when adjusted to each other, they have shown no increased risk of having poor sleep quality.
RESUMEN
During the early months of the COVID-19 pandemic, infection prevention and control (IP&C) for women in labor and mothers and newborns during delivery and receiving post-partum care was quite challenging for staff, patients, and support persons due to a relative lack of evidence-based practices, high rates of community transmission, and shortages of personal protective equipment (PPE). We present our IP&C policies and procedures for the obstetrical population developed from mid-March to mid-May 2020 when New York City served as the epicenter of the pandemic in the U.S. For patients, we describe screening for COVID-19, testing for SARS-CoV-2, and clearing patients from COVID-19 precautions. For staff, we address self-monitoring for symptoms, PPE in different clinical scenarios, and reducing staff exposures to SARS-CoV-2. For visitors/support persons, we address limiting them in labor and delivery, the postpartum units, and the NICU to promote staff and patient safety. We describe management of SARS-CoV-2-positive mothers and their newborns in both the well-baby nursery and in the neonatal ICU. Notably, in the well-baby nursery we do not separate SARS-CoV-2-positive mothers from their newborns, but emphasize maternal mask use and social distancing by placing newborns in isolates and asking mothers to remain 6 feet away unless feeding or changing their newborn. We also encourage direct breastfeeding and do not advocate early bathing. Newborns of SARS-CoV-2-positive mothers are considered persons under investigation (PUIs) until 14 days of life, the duration of the incubation period for SARS-CoV-2. We share two models of community-based care for PUI neonates. Finally, we provide our strategies for enhancing communication and education during the early months of the pandemic.
