Clinical Rounds

March 2012 
Volume 42  Number 3
Pages 27 - 29
  PDF Version Available!

The Joint Commission (TJC) has issued a Sentinel Event Alert that addresses the effects and risks of long shifts and cumulative days of extended work hours among nurses and other healthcare workers. Noting the proven association between nurse fatigue and incidence of errors, TJC makes these recommendations to healthcare facilities: * Assess the facility's fatigue-related risks, such as extended work shifts and hours. * Examine high-risk activities, such as patient hand-offs, that become even riskier when workers are fatigued, and initiate policies and procedures to improve patient safety. * Seek staff input on how to design work schedules that minimize the potential for fatigue. * Give staff opportunities to express concerns about fatigue and take action to address those concerns. * Implement a fatigue management plan that includes proven strategies for fighting fatigue. These include actively engaging in conversation (not just listening and nodding), physical activity, strategic caffeine consumption, and short naps. * Educate staff members about good sleep habits and the effects of fatigue on patient safety. "We have a culture of working long hours, and the impact of fatigue has not been a part of our consciousness," says Christopher P. Landrigan, MD, MPH, a nationally known sleep expert. "Most [healthcare workers] are unaware of sleep and circadian biology and the degree that it affects performance. And, most do not realize how much research supports the need to make changes."To read the full Alert, visit .Source: The Joint Commission. Health care worker fatigue and patient safety. Sentinel Event Alert. 2011;(48):1-4.Some women with breast cancer have reported memory problems and other cognitive impairments that seemed to be associated with chemotherapy-a condition informally known as "chemo brain." New research indicates that chemotherapy isn't the only culprit: neurologic impairment is associated with primary breast cancer, regardless

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