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errors, fatigue countermeasures, fatigue management, hospital staff nurses, nurse and patient safety



  1. Scott, Linda D.
  2. Hofmeister, Nancee
  3. Rogness, Neal
  4. Rogers, Ann E.


Background: Studies indicate that extended shifts worked by hospital staff nurses are associated with higher risk of errors. Long work hours coupled with insufficient sleep and fatigue are even riskier. Although other industries have developed programs to reduce fatigue-related errors and injury, fatigue countermeasures program for nurses (FCMPN) are lacking.


Objectives: The objective of this study was to evaluate the feasibility of an FCMPN for improving sleep duration and quality while reducing daytime sleepiness and patient care errors. Selected sleep variables, errors and drowsy driving, were evaluated among hospital staff nurses (n = 47) before and after FCMPN implementation.


Method: A one-group pretest-posttest repeated-measures approach was used. Participants provided data 2 weeks before the FCMPN, 4 weeks after receiving the intervention, and again at 3 months after intervention.


Results: Most of the nurses experienced poor sleep quality, severe daytime sleepiness, and decreased alertness at work and while operating a motor vehicle. After the FCMPN, significant improvements were noted in sleep duration, sleep quality, alertness, and error prevention. Although significant improvements were not found in daytime sleepiness scores, severity of daytime sleepiness appeared to decrease. Despite improvements in fatigue management, nurses reported feelings of guilt when engaging in FCMPN activities, especially strategic naps and relieved breaks.


Conclusions: Initial findings support the feasibility of using an FCMPN for mitigating fatigue, improving sleep, and reducing errors among hospital staff nurses. In future investigations, the acceptability, efficacy, and effectiveness of FCMPNs can be examined.