Factors Associated with Workplace Injuries Among Shift Work Nurses: A Cross-Sectional Study in an Ecuadorian Sample

<b>Background/Objectives:</b> Shift work schedules and mental and physical workloads affect the sleep homeostasis of nurses, increasing the risk of occupational injuries. This study aimed to investigate the relationship between sleep disturbances caused by shift schedules and the occurrence of needlestick and sharps injuries (NSIs) among nurses, considering significant worker and occupational factors. <b>Methods:</b> A total of 348 nurses from five hospitals of Santiago de Guayaquil, Ecuador, participated in this cross-sectional survey. Data on sociodemographic and occupational characteristics, work schedules, and NSI incidents during the previous six months were collected. Emotional status, sleepiness, and insomnia symptoms were assessed using validated questionnaires. Additionally, nurses with night shifts (fixed or rotating) were specifically assessed to estimate the relationship between NSIs and insomnia or sleepiness symptoms related to these types of shift work using logistic regression analyses. <b>Results:</b> Nurses whose schedule included night shifts showed a higher prevalence of NSIs than those with other shifts (33.2% vs. 29.0%; <i>p</i> < 0.05). High levels of depression, anxiety, and stress were associated with having had an NSI in the previous six months. Logistic regression showed that female sex (adjusted odds ratio, aOR 4.62, 95% CI: 1.65-12.97), less experience in the current clinical setting (aOR 3.12, 95% CI: 1.46-6.57), the use of psychotropic drugs (aOR 4.46, 95% CI: 1.51-13.17), and insomnia and sleepiness symptoms due to shift work (aOR 2.61, 95% CI: 1.15-5.91) increased NSI risk among nurses with night shifts. <b>Conclusions:</b> There is an acute need to explore the complex relationship between sleep troubles linked to shift work schedules, occupational factors, and the risk of occupational injuries and propose preventive strategies for enhancing nurses' sleep health and workplace safety.