A Shiftwork Education Program: Translating Non-Healthcare Evidence to Improve Nurse and Patient Safety

The role that fatigue plays as both a nurse and patient safety problem has for too long been swept under the cultural rug of healthcare. This culture has in past treated fatigue as a necessary evil, and rewarded fatigued care providers with near-martyr status. The emergence of literature documenting the incredible human cost of fatigue has brought this problem out into the shadows and placed it under the twin spotlights of nurse and patient safety. Other industries, notably aviation, mining, manufacturing, and transportation, have taken proactive steps to address this problem and have seen demonstrable success in worker and public safety. An added bonus has been sharp reduction in turnover in certain industries.

The American Nurses Association Position Statement on Nurse Fatigue calls upon nurses and employers to collaborate and employ evidence-based strategies to address the problem of nurse fatigue. Those industries that have proactively developed programs and policies to protect worker and public safety from the dangers of a fatigued workforce have reaped the benefits and contributed to the growing body of literature related to shift-work and fatigue.

This project examined the scope of the problem, documented how the healthcare environment itself contributes to the problem, identified non-healthcare solutions to the problem, and examine ways in which these solutions could translate to the high stakes, 24/7 healthcare workplace.

The Shift-Work Education program is suitable for both practicing professionals and (with minor adjustments) pre-licensure students. It is an attempt to place this insidious, largely unaddressed nurse and patient safety issue on par with sharps injuries, ergonomic injuries, and bloodborne pathogen exposure - topics which every school of nursing and healthcare facility expends considerable time and energy on annually. Culture change only happens with sustained effort on many fronts. This program has the potential to lay a foundation of proactive, ongoing nurse education around this crucial topic.