An Integrative Review

Abstract

Preventing work-related fatigue requires multifaceted approaches involving the organization, the clinical unit, and the individual.

Effect of time of birth on maternal morbidity during childbirth hospitalization in California

“…Rotating shifts typically result in shift lag disruption of circadian rhythms and acute sleep deprivation. 16, 39 While permanent night work allows for some degree of adaptation to altered day-night circadian time cues, it is common for night shift workers to have some degree of chronic sleep deprivation due to competing daytime demands that can make it difficult to achieve adequate sleep. Fatigue prevalence in nurses working in acute care settings was reported to be 71-92% in one study, compared with 38% in the general population, 16 and extended shifts and night work are common among both nurses and physicians.…”

“…16, 39 While permanent night work allows for some degree of adaptation to altered day-night circadian time cues, it is common for night shift workers to have some degree of chronic sleep deprivation due to competing daytime demands that can make it difficult to achieve adequate sleep. Fatigue prevalence in nurses working in acute care settings was reported to be 71-92% in one study, compared with 38% in the general population, 16 and extended shifts and night work are common among both nurses and physicians. 15-17 Both acute and chronic sleep deprivation degrade cognitive performance, resulting in impaired ability to integrate information, perform activities accurately, maintain vigilance and concentration, and communicate effectively.…”

“…44 Literature from sleep medicine, occupational safety, and health care domains supports the use of rest breaks and strategic scheduling of a nap during the night shift before the circadian nadir that occurs at about 4AM. 16, 39, 45 A full understanding of the reasons for the observed association between severe morbidity and night-time birth will require additional research. However, based on the available evidence, comprehensive strategies to improve the safety and quality of maternity care should include attention to the nocturnal conditions in hospital environments and evidence-based strategies for mitigating degradation of performance from fatigue and sleep deprivation.…”

The relationship between work‐related musculoskeletal disorders, chronic occupational fatigue, and work organization: A multi‐hospital cross‐sectional study

“…Work-related musculoskeletal disorders (WMSDs) and chronic occupational fatigue (COF) are harmful to nurses and patients. COF is a factor that has a significant negative effect on concentration, alertness, mood, problem-solving abilities, productivity, and performance (Barker & Nussbaum, 2011;Canadian Nursing Association, 2010;Sagherian, Clinton, Huijer, & Geiger-Brown, 2017;Smith-Miller, Shaw-Kokot, Curro, & Jones, 2014;The Joint Commission, 2011). When nurses are fatigued, errors and adverse patient outcomes are very likely (Caruso et al, 2017;The Joint Commission, 2011;Trinkoff et al, 2011).…”

Registered Nurse Perception of Patient Assignment Linking to Working Conditions and Outcomes

“…Allen (2015) identified factors that were considered by charge nurses when matching available RNs with unit patients, including patient demographics and acuity, nurse demographics and competencies, workload, work shift, and staffing levels. When considering such relationships, the RN-to-patient assignment might also be an important predictor of nurse working conditions (e.g., working hours or overtime and meal breaks) that were found to be associated with nurse outcomes (Kullberg, Bergenmar, & Sharp, 2016;Smith-Miller et al, 2014;Witkoski & Dickson, 2010). Of work environment factors, some factors (e.g., the type of unit, numbers of patients and RNs, shift rotation, or whether assignments are adjusted shift-to-shift based on changing acuity levels) could guide or constrain RN-to-patient assignment decisions, while other factors (e.g., RN workload and ability to have an appropriate meal break) could be affected by RN-topatient assignments.…”