In a recent webinar on Healthcare Worker Fatigue, OmniSure Healthcare Consultant, Karen Kruer, RN, discussed the link between healthcare worker fatigue and adverse events.   The correlation is well documented, she says, prompting The Joint Commission to issue a new Sentinel Event Alert: Healthcare Worker Fatigue and Patient Safety in December 2011. The Alert urges greater attention to preventing fatigue among healthcare workers and suggests specific actions for healthcare organizations to mitigate the risks.

Ms. Kruer noted that although some people are less impaired by insufficient sleep than others, several studies have shown that failure to obtain adequate sleep is an important contributor to medical error.  The data from nurses who participated in a Staff Nurse Fatigue and Patient Safety Study (2005) showed a significant relationship between lack of sleep in the prior 24 hours and the risk of making an error.  Although a 3.4% risk of an error or near miss sounds insignificant, it would translate to a probability of 34 events per day in an average teaching hospital with 1,000 nursing shifts per day.  In addition to jeopardizing patient safety, nurses who fail to obtain adequate amounts of sleep are also risking their own health and safety.

According to Ms. Kruer, while it is acknowledged that many factors contribute to fatigue, including but not limited to insufficient staffing and excessive workloads, the purpose of the Sentinel Event Alert is to address the effects and risks of an extended work day and of cumulative days of extended work hours.

Recent studies have shown that the 12-hour shifts favored by many nurses and frequent overtime are associated with difficulties staying awake on duty, reduced sleep times, and nearly triple the risk of making an error.  Fatigue can be exacerbated with increased numbers of shifts worked without a day off, and working more than four consecutive 12-hour shifts is associated with excessive fatigue and longer recovery times.

Even though the dangers of extended work hours (more than 12 hours) are well known, the healthcare industry has been slow to adopt changes, particularly with regard to nursing.  For more information, view the entire webinar for hospitals at: