Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives

Querstret, Dawn; O'Brien, Katie; Skene, Debra J.; Maben, Jill

doi:10.1016/j.ijnurstu.2019.103513

Cited by 51 publications

(53 citation statements)

References 66 publications

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“…Nurse managers and organisational policies, or lack thereof, have been identified as key challenges to staff napping overnight and it will only be through a change in culture, thinking and policy that staff will feel it appropriate and acceptable to nap on shift 1,3,13,15,16 . Until organisations can understand and fully accept this practice as a safety initiative for both staff and patients, staff will have little choice but to 'sneak' a nap, or push through their fatigue, possibly causing risk to themselves and their patients.…”

Section: Barriers To Night-shift Nappingmentioning

confidence: 99%

“…All major hospitals must provide access to surgical and procedural services 24 hours a day; therefore, perioperative nursing is an area impacted by fatigue and staff-related sleep disturbances 1 . While fatigue affects all nurses, those who work on night duty have been shown to have the greatest risk of cognitive impairment, thus potentially posing a risk to both their own and patient safety 2 .…”

Section: Introductionmentioning

confidence: 99%

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Asleep on the job: Can night shift napping provide greater safety for both staff and patients?

Gamble¹,

Foran²

2021

Journal of Perioperative Nursing

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Fatigue presents as an all-pervasive challenge to anyone who is engaged in shift work. While this affects all nurses, those who work on night duty have been shown to have the greatest risk of fatigue and cognitive impairment thus potentially posing a higher safety risk to themselves, the patients under their care and the wider community as nurses make their way home driving while drowsy. Despite robust evidence revealing the positive attributes of increased working abilities from napping on night duty, and the overall agreement by nurse managers and organisations, this practice has been slow to be introduced into nursing. Research revealed that 55 per cent of nurse managers felt the greatest barrier to implementation was the lack of policy and supervision around this practice. This discussion paper challenges nurses, managers and organisations to take note of current research, ACORN guidelines and work health and safety guidelines and start to change thinking and culture by looking at napping on night duty as a 'safety' implementation for staff, patients and the wider community. Policies and procedures should be developed and further research should be conducted into length and type of naps and subsequent positive and/or negative effects that may be reported by staff and health care facilities.

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Section: Barriers To Night-shift Nappingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Asleep on the job: Can night shift napping provide greater safety for both staff and patients?

Gamble¹,

Foran²

2021

Journal of Perioperative Nursing

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“…the Morningness-Eveningness Questionnaire (MEQ), consisting of 19 questions about personal daily sleep-wake habits and the times of day of preference of certain activities, with assigned points from 0 to 5, giving a possible overall score ranging from 16 to 86. Five categories can be identified: definitely E-type (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), moderately E-type (31-41), neither type or I-type (42-58), moderately M-type (59-69), and definitely M-type (70-86). For ease of interpretation, we considered moderately E-type as E-type (16-41 points) and moderately M-type as M-type (59-86 points).…”

Section: Instruments and Proceduresmentioning

confidence: 99%

“…Female nurses working in rotating night shift were found to have significantly lower mean scores in job satisfaction, sleep, and psychological well-being as compared to day shift workers [27] and even impaired sexual self-efficacy and sexual quality of life [28]. There is an extreme paucity of studies conducted on midwives, although they play an important role in medical care: a systematic review of sleep-related/fatigue-management including more than 8600 participants, 89% females, did not find studies conducted in midwives [29]. In the same year, a survey study by the American College of Nurse-Midwives Sleep and Safety Taskforce, conducted on more than 4350 certified nurse-midwives and midwives to identify sleepiness, found that midwives working shifts >12 h had higher rates of excessive daytime sleepiness compared with those who worked shifts of ≤12 h [30].…”

Section: Introductionmentioning

confidence: 99%

Individual Circadian Preference, Shift Work, and Risk of Medication Errors: A Cross-Sectional Web Survey among Italian Midwives

Cappadona

Simone

Giorgi

et al. 2020

IJERPH

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Background: In order to explore the possible association between chronotype and risk of medication errors and chronotype in Italian midwives, we conducted a web-based survey. The questionnaire comprised three main components: (1) demographic information, previous working experience, actual working schedule; (2) individual chronotype, either calculated by Morningness–Eveningness Questionnaire (MEQ); (3) self-perception of risk of medication error. Results: Midwives (n = 401) responded “yes, at least once” to the question dealing with self-perception of risk of medication error in 48.1% of cases. Cluster analysis showed that perception of risk of medication errors was associated with class of age 31–35 years, shift work schedule, working experience 6–10 years, and Intermediate-type MEQ score. Conclusions: Perception of the risk of medication errors is present in near one out of two midwives in Italy. In particular, younger midwives with lower working experience, engaged in shift work, and belonging to an Intermediate chronotype, seem to be at higher risk of potential medication error. Since early morning hours seem to represent highest risk frame for female healthcare workers, shift work is not always aligned with individual circadian preference. Assessment of chronotype could represent a method to identify healthcare personnel at higher risk of circadian disruption.

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“…This means that mental health nurses and the organizations for which they work will need to consider the importance of sleep not only in relation to nurse or consumer safety (Scott et al 2014), but also in relation to the ways in which nurses can be educated about how to enact good self‐care and stress management (Edwards & Burnard 2003; Kemper et al 2011). There is support for the implementation of a range of fatigue management strategies in healthcare settings including the use of napping of appropriate duration, light exposure, or attenuation, as well as consideration of types of shift in rostering (e.g., the detrimental effects of shifts that involve a quicker return to work; Querstret et al 2020). At a wider policy level, this also speaks to broader issues regarding the need for nursing organizations, reflected for example in a position statement by the American Academy of Nursing (Caruso et al 2017), to advocate for the use of best practice evidence regarding shift design and fatigue management processes.…”

Section: Relevance To Clinical Practicementioning

confidence: 99%

Considering the relationship between sleep and empathy and compassion in mental health nurses: It’s time

Gerace

Rigney

2020

Int J Mental Health Nurs

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Sleep plays a critical role in overall health, well-being, and daytime functioning. Provision of 24-hour care means that nurses undertake shift work and therefore have been found to commonly not get the recommended amount of sleep, resulting in sleep deprivation. Research to date has focused on how sleep deprivation impacts their cognitive performance (e.g., reaction time, memory consolidation); however, less considered is how nurses' sleep impacts on their ability to understand and provide emotional care to consumers. In this paper, we examine how sleep may influence nurses' ability to empathize and provide compassionate care, both of which are fundamental aspects of their work. We begin by considering the unique challenges nurses face as shift workers and the impact of sleep on physical and psychological functioning. We examine how empathy and compassion drive nurses' attempts to understand consumers' perspectives and experiences and motivate them to want to help those in their care. Work directly investigating the relationship between sleep and these processes indicates emotional recognition and experience are hampered by poor sleep, with greater compassion towards oneself or from others associated with better sleep. Much of this work has, however, been conducted outside of the nursing or health professional space. We discuss issues that need to be addressed in order to move understanding forward regarding how sleep impacts on mental health nurses' empathy and compassion, as well as how an understanding of the sleep-empathy/compassion link should be an important priority for nurse education and well-being.

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Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives

Cited by 51 publications

References 66 publications

Asleep on the job: Can night shift napping provide greater safety for both staff and patients?

Asleep on the job: Can night shift napping provide greater safety for both staff and patients?

Individual Circadian Preference, Shift Work, and Risk of Medication Errors: A Cross-Sectional Web Survey among Italian Midwives

Considering the relationship between sleep and empathy and compassion in mental health nurses: It’s time

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