title: An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study.
abstract: 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.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, Michigan 49503, USA. scottl@gvsu.edu
authors.forename: Linda D
authors.initials: LD
authors.lastname: Scott
authors.forename: Nancee
authors.initials: N
authors.lastname: Hofmeister
authors.forename: Neal
authors.initials: N
authors.lastname: Rogness
authors.forename: Ann E
authors.initials: AE
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001334:Automobile Driving / Q000706:statistics & numerical data; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000451:nursing / Q000517:prevention & control / Q000706:statistics & numerical data; D008824:Michigan; D008875:Middle Aged; D009551:Night Care; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016272:Occupational Health; D010865:Pilot Projects; D015397:Program Evaluation; D011446:Prospective Studies; D017751:Safety Management / Q000458:organization & administration*; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016526:Workload