1. Steege, Linsey M. PhD
  2. Pinekenstein, Barbara J. DNP, RN-BC, CPHIMS
  3. Rainbow, Jessica G. BSN, RN
  4. Arsenault Knudsen, Elise MS, RN, ACNS-BC


OBJECTIVE: The aim of this article is to describe the current state of fatigue risk management systems (FRMSs) to address nurse fatigue in hospitals.


BACKGROUND: Little is known about the current state of FRMS implementation and adoption of national recommendations in nursing work systems.


METHODS: This study used a sequential exploratory mixed-methods design including a survey of nurse leaders from across the United States.


RESULTS: Adoption of evidence-based policies to address fatigue is both limited and variable depending on the policy. Nurse leaders indicate that while nurse fatigue is an important issue and has negative consequences, the social norms of fatigue have not allowed the elevation of this topic to trigger sweeping organizational change.


CONCLUSIONS: This study provides a framework for implementation of FRMSs as an innovation, highlighting the critical role of nurse leaders in adoption and dissemination. Raising the visibility of fatigue across the organization is a critical 1st step.