Home E-Weekly January 7, 2014

Tired Nurses Make Decisions They Regret

Published: January 6, 2014

There's a link between on-the-job exhaustion and regrettable clinical decisions, says a study considering the issue in the American Journal of Critical Care.

Nurses who regretted decisions they'd made reported more fatigue, more daytime sleepiness, less between-shift recovery and worse sleep quality than did nurses without decision regret, a new study has found.

Of the 605 nurses researchers at the University of Illinois at Chicago College of Nursing surveyed, 29% reported making decisions they regretted.

The study's authors say the amount of sleep nurses get impacts their abilities to stay alert, vigilant and safe. Specifically, sleep deprivation effects cognition, reduces response times and increases risk-taking behaviors. Acute and chronic sleep deprivation inhibits working memory, alertness, attention, vigilance and decision making, they add.

Additionally, the study notes fatigued nurses are less likely to fully recover during non-working hours, raising the risk of them becoming chronically fatigued, which puts them at greater risk of suffering work-related injuries, illnesses, absenteeism and making impaired decisions.

According to the study, nurses need to take it upon themselves to practice good sleep hygiene. Facility leaders, meanwhile, should ensure schedules permit staff adequate time away from work to recover and avoid extended shifts and excessive consecutive workdays.

Healthcare facilities should routinely educate nursing staffs on how to manage fatigue and incorporate fatigue countermeasures into routine practice, say the researchers, adding, "By working together to manage fatigue, nurses and employers can ensure that patients receive care from alert, vigilant, and safe employees."

Daniel Cook

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