The National Association of Neonatal Nurses has issued a new position statement outlining risk-reduction strategies to decrease nurse fatigue and sleep deprivation while improving the overall safety of patients and nurses.
For Employers and Nursing Managers/Directors:
1.) Promote a culture that recognizes nurse fatigue as an unacceptable risk
2.) Schedule sensibly. If an employee works both a day and night shift in the same week, it is recommended that he or she work the day shift first, followed by the night shift. After working a night shift, one day of rest is recommended before returning to the work environment.
3.) Implement guidelines to limit the number of patient-care hours a nurse can provide. Limitations for safe patient care include a maximum of 12 hours in a 24-hour period, and no more than 60 hours in a 7-day period. In emergency situations, a staff nurse may be needed to work for a longer period of time, but this should be an exception due to unusual circumstances, such as severe weather.
4.) Provide a sufficient number of off-duty hours to allow an uninterrupted sleep cycle
of at least 8 hours
5.) Implement preplanned arrangements to relieve an RN if he or she is scheduled on-call for the next consecutive shift to allow time for a minimum of 8 hours of sleep.
The number of on-call shifts in a 7-day period should be incorporated into an RNs
total scheduled hours.
6.) Incorporate orientation to on-call as a part of new-hire orientation at all healthcare
7.) Consider permanent shift assignments; they may lessen fatigue effects (as opposed to rotating shifts)
For Bedside Registered Nurses:
1.) Nurses should uphold their ethical responsibility to arrive at work adequately rested and prepared to provide patient care
2.) Nurses need to consider that multiple workloads and work settings affect fatigue
3.) Bedside registered nurses should limit the number of hours they agree to work to a maximum of 12 hours in a 24-hour period (except in emergency situations), and to
no more than 60 hours in a 7-day period.