What do we do about tired nurses?

Friday, March 11, 2016: 9:35 AM
Coronado L (Coronado Springs Resort)
Deborah J Maust Martin, DNP, MBA, RN, NE-BC, FACHE , Professional Practice, Banner Health, Phoenix, AZ

Handout (474.1 kB)

Purpose:
The purpose of this project was to assess nurse fatigue in two different shift lengths using the Occupational Exhaustion Fatigue and Recovery scale (OFER) to measure acute and chronic fatigue as well as inter-shift recovery.

Relevance/Significance:
This pilot research study aligns with two of the conference objectives: 1. Disseminate nursing research to drive evidence-based practice, and 2. Relate exemplary work environment practices to patient and nursing outcomes. Shift lengths need to be explored to provide a better work environment for nurses that the literature relates to better patient outcomes.

Strategy and Implementation:
The change for this project was to change shift lengths from 12-hours to 8-hours for a 4-week period of time so that the fatigue levels associated with 12-hour and 8-hour shifts could be evaluated. Nurses volunteered in sets of three for the project. The volunteers needed to be in sets of three so that a 24-hour period was covered by the three 8-hour shifts. This is taking into consideration the context of the environment in which the change will take place, where care is provided by the nurses 24-hours a day, every day of the week. This form of scheduling provided the same nurse coverage pre- and post-shift length change, providing one nurse for the unit staffing for a 24-hour period. The three nurses in each set collaborated among themselves to determine days scheduled as well as weekends that they would have off. Nine nurses volunteered for the project.

Evaluation:
Median difference for acute fatigue was p = .279, not significant. Median difference for chronic fatigue was p = .144, not significant. Median difference for inter-shift recovery was p = .027. With a large effect size and high power, the findings suggest there is a difference in 12-hour shifts and 8-hour shifts for a decreased recovery between shifts, an unexpected finding.

Implications for Practice:
Consideration of a variety of shift lengths and FTE are needed for the nursing workforce. As a Joint commission Sentinel Event Alert, it needs to be top of mind for nurse leaders and direct care nurses.