ARTICLE #6
Preventing Healthcare Worker Fatigue
From Coverys Risk Management
(Janelle Mickelson, RN, BSN, MSA, CPHRM)
Healthcare organizations providing 24-hour care have always faced staffing challenges.
But, with emerging trends such as nursing shortages and shorter lengths of hospital stays, nurses’ shifts have increased well beyond the traditional eight-hour shift. In many facilities, it is common practice to have 10- to 12-hour shifts, with some nurses reporting even longer times at work — nearly 24 consecutive hours.
Unsurprisingly, these extended work hours bring up concerns of worker fatigue and its effects on patient safety. From the Accreditation Council for Graduate Medical Education (ACGME) to the Joint Commission, strong recommendations …show more content…
In those situations, it may be helpful to follow the guidelines published by the National Highway Traffic Safety Administration when establishing organizational policies to help reduce provider fatigue on the job:
Recognize that the urge to sleep is very strong between 2:00 a.m. and 9:00 a.m., and especially between 3:00 a.m. and 5:00 a.m. Avoid assigning unnecessary work at that time.
Schedule backup workers during times that providers are most likely to be fatigued.
Create an area where healthcare workers can rest when appropriate. The sleep environment should be quiet and dark. It should have adequate ventilation and a comfortable temperature to allow daytime sleep.
Understand that behavioral changes, such as irritability, may indicate dangerous levels of fatigue, and respond accordingly.
Educate healthcare workers with respect to healthy sleep habits. These include going to sleep immediately after working a night shift to maximize sleep length, and using naps strategically (e.g. a two-hour nap before a night shift will help prevent sleepiness. When a two-hour nap isn’t possible, naps should be less than 45 minutes, to avoid sleeping so deeply that it makes alertness more difficult to …show more content…
Ask staff members for input on designing work schedules to minimize fatigue potential.
Provide opportunities for staff members to express their concerns about fatigue.
Encourage staff members who work extended work shifts or hours to use teamwork as a supportive strategy and to protect patients from potential harm.
Consider fatigue as a potentially contributing factor when reviewing all adverse events.
Fatigue Risk Management Systems
As suggested by the Joint Commission, once a corporate commitment is made to reduce healthcare worker fatigue and thus make it a safer environment for patients, a fatigue risk management system (FRMS) should be developed.
The key characteristics of an FRMS include being science-based, data-driven, cooperative, fully implemented, integrated, continuously improved, budgeted, and owned. Your FRMS should address six key dimensions to be effective:
Workload-Staffing Balance
Shift or Duty-Rest Scheduling
Employee Fatigue Training & Sleep Disorder Management
Work Environment Design
Alertness Monitoring & Fitness for Duty
Processes for Monitoring & Evaluating Fatigue-Related
Preventing Healthcare Worker Fatigue
From Coverys Risk Management
(Janelle Mickelson, RN, BSN, MSA, CPHRM)
Healthcare organizations providing 24-hour care have always faced staffing challenges.
But, with emerging trends such as nursing shortages and shorter lengths of hospital stays, nurses’ shifts have increased well beyond the traditional eight-hour shift. In many facilities, it is common practice to have 10- to 12-hour shifts, with some nurses reporting even longer times at work — nearly 24 consecutive hours.
Unsurprisingly, these extended work hours bring up concerns of worker fatigue and its effects on patient safety. From the Accreditation Council for Graduate Medical Education (ACGME) to the Joint Commission, strong recommendations …show more content…
In those situations, it may be helpful to follow the guidelines published by the National Highway Traffic Safety Administration when establishing organizational policies to help reduce provider fatigue on the job:
Recognize that the urge to sleep is very strong between 2:00 a.m. and 9:00 a.m., and especially between 3:00 a.m. and 5:00 a.m. Avoid assigning unnecessary work at that time.
Schedule backup workers during times that providers are most likely to be fatigued.
Create an area where healthcare workers can rest when appropriate. The sleep environment should be quiet and dark. It should have adequate ventilation and a comfortable temperature to allow daytime sleep.
Understand that behavioral changes, such as irritability, may indicate dangerous levels of fatigue, and respond accordingly.
Educate healthcare workers with respect to healthy sleep habits. These include going to sleep immediately after working a night shift to maximize sleep length, and using naps strategically (e.g. a two-hour nap before a night shift will help prevent sleepiness. When a two-hour nap isn’t possible, naps should be less than 45 minutes, to avoid sleeping so deeply that it makes alertness more difficult to …show more content…
Ask staff members for input on designing work schedules to minimize fatigue potential.
Provide opportunities for staff members to express their concerns about fatigue.
Encourage staff members who work extended work shifts or hours to use teamwork as a supportive strategy and to protect patients from potential harm.
Consider fatigue as a potentially contributing factor when reviewing all adverse events.
Fatigue Risk Management Systems
As suggested by the Joint Commission, once a corporate commitment is made to reduce healthcare worker fatigue and thus make it a safer environment for patients, a fatigue risk management system (FRMS) should be developed.
The key characteristics of an FRMS include being science-based, data-driven, cooperative, fully implemented, integrated, continuously improved, budgeted, and owned. Your FRMS should address six key dimensions to be effective:
Workload-Staffing Balance
Shift or Duty-Rest Scheduling
Employee Fatigue Training & Sleep Disorder Management
Work Environment Design
Alertness Monitoring & Fitness for Duty
Processes for Monitoring & Evaluating Fatigue-Related