Education Career Articles

Connect Facebook Connect Twitter Connect Google+ Connect Pinterest Connect Stumbleupon

Critical Error: The Role of Nurse Fatigue in Patient Safety

Career News August 3, 2013

Nurses fatigue patient safety is a topical subject in modern health care because responsibility for patient care is increasingly being shifted to nurses. For instance, U.S. Politics Today recently reported on a study at the University of Pennsylvania’s School of Nursing, which linked an increase in nurse fatigue due to higher than average patient loads, with a corresponding increase in patient infection, injury, and death.

But what are nurse fatigue, and what do medical professionals need to know about it?

Nurse Fatigue—Defined

According to the U.S. Department of Health & Human Services‘ Agency for Healthcare Research and Quality, “fatigue” is sometimes considered synonymous with “sleepiness,” but the two conditions are actually distinct. “Sleepiness” means a person feels the need to go to sleep, whereas “fatigue” is “an overwhelming sense of tiredness, lack of energy, and a feeling of exhaustion associated with impaired physical and/or cognitive functioning.” Nonetheless, a person experiencing fatigue may experience a sensation of sleepiness.

Causes of Nurse Fatigue

The Wisconsin Nurses Association has identified three primary causes of nurse fatigue. They are insufficient sleep, nonstandard work hours, and being awake for too many hours. The Association cites the findings of Ann Rogers, Ph.D., RN, and FAAN, whose landmark study found that RNs average well under the necessary eight hours of sleep on workdays; they work extended shifts of 12 hours or longer, providing patient care while standing up and being physically active; and finally, that nurses stay awake for too many hours in a row. A nurse who has been awake for 19 hours has the cognitive impairment of a person whose blood alcohol content is 0.05 percent, and a person who has stayed awake for 24 hours has the cognitive impairment of a person with a blood alcohol content of 0.10 percent.

Effects of Nurse Fatigue

The Joint Commission, a non-profit that accredits more than 19,000 American health care organizations and programs, recently issued a Sentinel Event Alert because it found nurses fatigue patient safety to be a recurring national problem with severe consequences. The Alert noted that nurses can suffer a variety of impairments if they are excessively fatigued, including memory lapses, compromised problem solving, diminished reaction time, reduced empathy, and an inability to stay focused.

Since nurses must make key decisions to provide quality patient care, nurse fatigue has a deleterious impact on patient safety. The Alert noted that nurses who work shifts in excess of 12.5 hours are three times more likely to err in patient care, to be less vigilant, and to suffer more occupational injuries. Thus, both nurses and their patients suffer when nurses are fatigued.

Preventative Measures to Avoid Nurse Fatigue

The Joint Commission recommends that organizations review staffing policies, to ensure that fatigue isn’t a de facto job requirement. It recommends ensuring that patient hand-offs, which occur at a time when nurses going off-shift are likely to be fatigued, are not compromised by nurses fatigue patient safety. Organizations should work collaboratively with staff to design shifts that don’t cause fatigue, and provide education and support around the problem of fatigue. Double-safety checks should be implemented for critical patient care tasks, and if an adverse event occurs, the potential role of fatigue should always be considered.

The Wisconsin Nurses Association also suggests that nurses should also be trained to confront other nurses who are impaired by fatigue and proactively document unsafe staffing levels. It recommends that nursing schools and professional associations should develop curricula and public education campaigns designed to alert both medical professionals and the general public about the patient safety impact of nurse fatigue and the need to maintain safe staffing levels.

Finally, the Rogers study recommends that nurses working extended shifts ameliorate their fatigue and increase alertness by taking frequent brief rest breaks (including naps, if possible), using caffeine in moderation, and exercising briskly from time to time, for up to ten minute interludes.

Showing schools in your area

Matching School Ads
5 Program(s) Found
  • Fortis offers nursing programs including ADN, PN, BSN degrees, and more
  • 40+ schools in 15 states including Florida, Arizona, Ohio, and Virginia
  • All colleges are accredited by ABHES, ACCSC, ACICS, or other accrediting bodies
  • Fortis Online serves benefits to US military service members
  • Grants & scholarship aid may be available for qualifying students
  • Financial Aid
5 Program(s) Found
  • Why Earn Your Degree from GCU?
  • Options: Choose from a variety of undergraduate and graduate degree programs in Business, Nursing, Psychology, Education & more!
  • Convenience: Complete courses online, on campus, or a combination of both!
  • Earlier Graduation: Our 4-credit courses allow you to complete your degree program in less time.
  • Transfer Friendly: We will request your transcripts, evaluate your graduate coursework, and determine your anticipated graduation date within 24 hours.
  • Quality: Grand Canyon University was founded in 1949 and is regionally accredited. Learn more today!
Good for Working Adults
  • Accredited
  • Online Courses
  • Flexible Scheduling
  • Accelerated Programs
  • Financial Aid
  • Transferable Credits
  • View Certificates, Associates or Bachelors Degree Programs in Medical Assisting Near YOU!
  • Free Information for Medical Assisting, Healthcare Administration, Medical Billing, Coding & Transcription Degree Programs & MORE.
  • Enter YOUR Needs and Requirements & Get Matched to the Perfect Campus or Online Degree Programs.
  • Accredited, Flexible and Affordable Medical Assisting Programs that Fit Your Time & Budget. Use our Matching Service - It's Easy and FREE!
  • Online Courses

Showing schools in your area

Matching School Ads
5 Program(s) Found
  • Do you aspire to fulfill an evolving healthcare role as a highly-qualified nursing professional? GCU is the place for you.
  • RNs, pursue your BSN or MSN conveniently online, backed by the legacy of GCU's traditional campus.
  • GCU's bachelor's and master's programs prepare students to fill roles in direct care, management, health education and administrative disciplines.
  • The baccalaureate degree in nursing and master's degree in nursing at GCU are accredited by the Commission on Collegiate Nursing Education
  • Develop with hands-on practice, online and lab simulations and in depth peer discussions exploring best practices.
Good for Working Adults
  • Accredited
  • Online Courses
  • Flexible Scheduling
  • Accelerated Programs
  • Financial Aid
  • Transferable Credits
  • View Certificates, Associates or Bachelors Degree Programs in Medical Assisting Near YOU!
  • Free Information for Medical Assisting, Healthcare Administration, Medical Billing, Coding & Transcription Degree Programs & MORE.
  • Enter YOUR Needs and Requirements & Get Matched to the Perfect Campus or Online Degree Programs.
  • Accredited, Flexible and Affordable Medical Assisting Programs that Fit Your Time & Budget. Use our Matching Service - It's Easy and FREE!
  • Online Courses

Login to your account

Can't remember your Password ?

Register for this site!