COMMENTARY

Running on Empty: Fatigue and Healthcare Professionals

Claire C. Caruso, PhD, RN

Disclosures

August 02, 2012

Editorial Collaboration

Medscape &

In This Article

National Efforts to Improve Sleep Health

In recognition of the widespread negative effects of poor sleep on the individual, the workplace, and the community, a growing number of US government organizations in the US Department of Health and Human Services are targeting sleep health. These include Healthy People 2020 (the 10-year health objectives for the United States); several institutes of the National Institutes of Health, including the National Center on Sleep Disorders Research; the Centers for Disease Control and Prevention; and the National Institute for Occupational Safety and Health (NIOSH). A goal of NIOSH's National Occupational Research Agenda for Healthcare and Social Assistance is for healthcare organizations to adopt best practices for scheduling and staffing that minimize excessive workload and other factors associated with fatigue.[44]

Healthy People 2020 recognizes that strong scientific evidence links better sleep health to reduced rates of disease, injury, disability, and premature death. In 2010, Healthy People 2020 launched a new chapter on sleep health that includes 3 objectives for adults:

  • Increase the proportion who get 7 or more hours of sleep per day;

  • Increase the proportion with sleep apnea who seek medical evaluation; and

  • Reduce the rate of vehicular crashes attributed to drowsy driving.[45]

Recently, the Joint Commission issued a sentinel event alert about healthcare worker fatigue and patient safety.[46] The Joint Commission gave several suggestions for healthcare organizations to reduce risks from fatigue:

  • Examine and improve work schedules, staffing, and hand-off processes;

  • Consider fatigue as a factor in all adverse events;

  • Involve staff in the design of their schedules;

  • Create and implement a fatigue management plan;

  • Educate staff about sleep and fatigue;

  • Support staff who work long shifts; and

  • Lastly, encourage organizations that allow naps during the work shift to provide good sleep environments and adequate release from work responsibilities.

For more information on this topic, including additional strategies for healthcare employers, managers, and workers, see the NIOSH resource Work Schedules: Shift Work and Long Work Hours. NIOSH is also developing new training programs to relay coping strategies for shift work and long work hours. They can be accessed via this Website when they become available.

The opinions and conclusions in this article are those of the author and do not necessarily represent the views of NIOSH.

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