Nurse Fatigue Advocacy Dr Wishnia Reda Mesallam

When nurses do good: We did it!

When there is any error:

The American Nurses Association (ANA) calls for stronger collaboration between registered nurses (RNs) and their employers to reduce the risks of nurse fatigue for patients and nurses associated with shift work and long hours, and emphasizes strengthening a culture of safety in the work environment”. (ANA, 2014) According to the joint commission sentinel event alert (2015): “The link between health care worker fatigue and adverse events is well documented, with a substantial number of studies indicating that the practice of extended work hours contributes to high levels of worker fatigue and reduced productivity”. “Extended work hours were a contributing factor in needle stick injuries among nurses”. (Trinkoff, Le, Geiger-Brown, & Lipscomb, 2007.p.156)

Nurses who work long shifts are more likely to be burned out, dissatisfied with their job, and intend to leave their job within a year” (Stempfel A.,Sloane D. &Aiken L. p.2506)

Fatigued nurses and car accidents “ Fatigue-related problems are believed to cost the United States an estimated $18 billion dollars per year in lost productivity and accidents. More than 1,500 fatalities, 100,000 crashes, and 76,000 injuries annually are attributed to fatigue-related drowsiness on the highway”. (Thomas et al., 2006)

Causes:

Effects:

You don’t give what you don’t have! IOM, patient centered care is to:“ identify, respect, and care about patients’ differences, values, preferences, and expressed needs; relieve pain and suffering; coordinate continuous care; listen to; clearly inform, communicate with; educate patients, share decision making and management; and continuously advocate, disease prevention, wellness, and promotion of healthy life style” (Finkelman A. Kenner C p.266).

Clinical Information systems/Integrated and comprehensive team care: IOM has established guidelines about the fifth core competency which is: informatics. “to communicate, manage knowledge, mitigate error, and support decision making using information technology” (Finkelman A. Kenner C p.400).

Care Coordination: Care coordination is established to: “prevent errors that occur when multiple healthcare providers are involved” (Finkelman A. Kenner C p. 272)

Extended hours shift policy: “The 12-hour shifts favored by many nurses and frequent overtime are associated with difficulties staying awake on duty, reduced sleep times, and nearly triple the risk of making an error”. (Scott L, Rogers A, Hwang WT, et al)

This is what nurses need

To avoid this:

Interventions: Changing shift length Hiring more nurses Rotations of shifts in critical areas Providing stress management workshops Giving special care to nurses who work in emergency department, oncology and palliative care, hospice, high risk areas by shortening their shifts, providing counselling for stress coping strategies, giving nap breaks, and collaborating with their work mates and supervisors

References American Nurses Association. (2014, November 1). Retrieved December 24, 2015, from Finkelman, A., & Kenner, C. (2013). Professional nursing concepts: Competencies for quality leadership. Sudbury, Mass.: Jones and Bartlett. (2015). Retrieved October 17, Health care worker fatigue and patient safety. (2011). The Joint Commission Sentinel Event Alert, (48). Retrieved December 22, Rogers, A. (2008). The Effects of Fatigue and Sleepiness on Nurse Performance and Patient Safety. In Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality, U.S. Dept. of Health and Human Services. Scott L, Rogers A, Hwang WT, et al. The effects of critical care nurse work hours on vigilance and patient safety. J Crit Care Nurs Jan;15(4):30–7 Stimpfel, A., Sloane, D., & Aiken, L. (2012). The Longer The Shifts For Hospital Nurses, The Higher The Levels Of Burnout And Patient Dissatisfaction. Health Affairs, 31(11), Retrieved December 24, 2015 Thomas, N., Depaul Brown, N., Hodges, L., Gandy, J., Lawson, L., Lord, J., & Williams, K. (2006). Factors associated with work-related injury among hospital employees: A case- control study. AAOHN, 54(1), Retrieved January 7, 2016