| Publication Date |
2014 |
| Personal Author |
Brown, J. G.; Hinds, P. S.; Warren, J.; Scharf, S.; Zhu, S.; Wieroney, M.; Blair, L. |
| Page Count |
43 |
| Abstract |
Managing worker fatigue is critical to workplace productivity and worker safety and health. Because fatigue in the workplace is modifiable, it is a good target to contain organizational costs due to errors, accidents and injuries. Hospital nurses are one of the largest occupational groups that routinely do shift-work and extended work hours; 60-70% of the 3 million U.S. nurses work in hospitals. The goal of this research study was to pilot test interventions that have been successful to reduce fatigue in other industries but have not been attempted in hospital nursing. Reducing risks to patients and to nurses' health due to fatigue is a shared responsibility of nurses and their employers, so interventions were conducted at both the nurse and the hospital unit level. There were four interventions that were evaluated: (1) web-based education to teach nurses how to cope with extended work hours and shiftwork, written by NIOSH, (2) screening for symptoms of a sleep disorder and referral for sleep evaluation, (3) implementation of a 25-30 minute nap during the night shift, (4) assessment of fatigue risk management software as a decision support tool to reduce fatiguing schedules for nurses. A process evaluation was used to assess facilitators and barriers to intervention success. Two hospitals in the mid-Atlantic region were recruited and each provided access to four nursing units. Nurses were consented (n=114) then baseline measures of sleep quantity and quality, fatigue, sleepiness, alertness, schedule patterns, cumulative fatigue risk, and sleep disorder symptoms were obtained. Units were randomized to intervention or control. We found that napping and web-based education were the two interventions that had the best uptake in hospitals. Napping was enthusiastically endorsed on one unit, maintained after the intervention was over, and will be extended to two other non-study nursing units in one hospital. But napping uptake was uneven even with executive and managerial support, and the reasons for this will require additional study. Nurses reported improved alertness during the night shift and a reduction or elimination of drowsy driving after taking a brief nap. Web-based education was easy to implement, but needed to be shortened to be acceptable by nurses. They did find the content to be useful. We found that fatigue risk management software is able to detect patterns of enterprise wide fatigue risk and could be used to assess unit level or individual nurse level fatigue. This was not a desired solution for the two hospitals where we provided cumulative fatigue risk data based on historical time clock data. These hospitals preferred their own internal solutions to managing schedules. Providing nurses with information about their individual risk for potential sleep disorders was also not successful, and we believe that significant work would need to be done to understand how to communicate risk in order to propel action for this problem in an occupational setting. |
| Keywords |
|
| Source Agency |
|
| NTIS Subject Category |
|
| Corporate Authors |
Maryland Univ. at Baltimore. School of Nursing.; National Inst. for Occupational Safety and Health, Washington, DC. |
| Document Type |
Technical Report |
| Title Note |
Final rept. (9/1/11 - 8/31/14). |
| NTIS Issue Number |
201914 |
