Grand Valley State University Study Finds Connection Between Nurse Fatigue, Patient Errors


GRAND RAPIDS, Mich. -- A major nationwide study co- authored by a Grand Valley State University nursing professor found that the  long hours worked by hospital staff nurses may have adverse effects on patient  safety.


Linda Scott, Grand Valley associate professor of nursing in the Kirkhof

College of Nursing, said after studying the work habits of 393 hospital staff

nurses, the research team found that nurses working more than 12.5 consecutive

hours were three times more likely to make an error than nurses working

shorter hours.  Working overtime at the end of a shift also increased the risk

of making an error.


The study, led by University of Pennsylvania nursing professor Ann Rogers,

will be published in the July/August issue of Health Affairs.


The study was conducted by giving nurses logbooks to track hours worked,

overtime, days off and sleep/wake patterns for 28 days.  Participants were

asked to describe errors or near errors that might have occurred during their

work periods.


Participants reported 199 errors and 213 near errors during the data-

gathering period.  More than half of the errors (58 percent) involved

medication administration; other errors included procedural errors (18

percent), charting errors (12 percent), and transcription errors (7 percent).


Researchers found that most hospital nurses no longer work eight-hour day,

evening or night shifts.  Instead, they may be scheduled for 12-hour, 16-hour

or even 20-hour shifts.  Even when working extended shifts (less than or equal

to 12.5 hours), they were rarely able to leave the hospital at the end of

their scheduled shift.  All participants reported working overtime at least

once during the data-gathering period, and one-third of the nurses reported

working overtime every day they worked.


"Both the use of extended shifts (greater than or equal to 12 hours) and

overtime documented in this study pose significant threats to patient safety,"

Rogers said.  "In fact, the routine use of 12-hour shifts should be curtailed

and overtime -- especially overtime associated with 12-hour shifts -- should

be eliminated." 


The study was funded with a grant from the Agency for Healthcare Research

and Quality in Maryland.  Scott and Rogers are conducting a correlating study

to research the work hours of critical care nurses.


Scott and Rogers are expected to speak before their respective state

legislatures on nurse fatigue and patient safety.  Scott is also working with

the Michigan Nurses Association on patient safety legislation.


"We need to educate nurses and hospitals about fatigue," she said.  "It's

a shared responsibility and both parties are accountable.  This is a national

problem that will likely have a national effect."


Source:  Grand Valley State University

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