ADDRESSING NURSE FATIGUE TO PROMOTE SAFETY AND HEALTH: A JOINT RESPONSIBILTY BARBARA B. HOBBS, PHD,...
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Transcript of ADDRESSING NURSE FATIGUE TO PROMOTE SAFETY AND HEALTH: A JOINT RESPONSIBILTY BARBARA B. HOBBS, PHD,...
ADDRESSING NURSE FATIGUE TO PROMOTE SAFETY AND HEALTH: A JOINT RESPONSIBILTY
BARBARA B. HOBBS, PHD, RN
SOUTH DAKOTA NURSES ASSOCIATION
OCTOBER 5, 2015
PREVAILING MESSAGES
Little acceptance by nursesWe all worked nights and shiftwork; Expected as part of the job. New RNs need to “get over it” I am safe even when I tired.RNs should be fired for napping; it is patient
abandonmentPatients come first; meal breaks are a luxury
PURPOSE
Articulates the ANA’s position of the joint responsibility of RNs and Employers to:Reduce risks r/t sleepiness and fatigueCreate and sustain a culture of safetyHealthy work environmentWork-life balance
DEFINITIONS
Fatigue – impaired function resulting from physical labor or mental exertion.Physical – reduces physical capacity Objective – reduced productivitySubjective – weary, unmotivated
Sleepiness – Inc. propensity to fall asleep resulting from an imbalance of the sleep/wake cycle.Decreased sleep quality and quantity
REVIEW OF THE EVIDENCE
SHIFTWORK & LONG WORKING HOURS
Growing body of evidence on the effect inadequate sleep and resulting fatigue Inability to provide optimal patient careRisk of error; reduced job performanceHealth and safety issue Safety, drowsy drivingDirect costs and financial impact
JOINT RESPONSIBILITIES OF RNS AND EMPLOYERS
Collaboration to achieve safe, quality care for patients.
Supports AACN Standards for Establishing and Sustaining Healthy Work Environments (AACN, 2005)
Recommendations to adopt evidence-based strategies to reduce health and safety risks (JCAHO, 2001& 2012)
IOM (2004) recommendations not exceed 12 Hrs. in 24 Hrs. or60 total Hrs. / 7 days
Best Evidence more than 40 Hrs. per 7 days linked patient safety
and nurse health.
ANA Recommendation≤ 40 Hrs.- (paid + unpaid) work in 7 days
RNS’ ETHICAL RESPONSIBILITY
Address fatigue and sleepiness in the workplace leading to harm or prevent optional care;
Practice healthy behaviors;Take meals, rest breaks;
Implement fatigue countermeasuresnaps, caffeine, exercise, etc.;
may refuse an assignment that compromises availability of sufficient time to sleep;
Implement fatigue countermeasures 11 evidence-based strategies
seek health care provider input when fatigue or health symptoms are unresolved.
EMPLOYERS’ RESPONSIBILITY
Establish a culture of safety
Adopt policy that allow RN to accept or reject assignments to prevent risks from fatigue.
Limit work hours to 40 Hrs. / 7 daysIncluding meetings, in-service, on-call hours
Regularly audit scheduling practices
Verify nurses get breaks and meals;
Support 20-30 minute naps;
Limit extra shifts scheduled;
Adopt and implement ANA’s key (7) and additional workforce and scheduling strategies.
TAKE HOME MESSAGE:
Reflect on your own habitssleep/wake; meal breaks, exercise
Know and follow the evidenceRole model healthy work behaviors Communicate & support implementation of
the ANA recommendations.