Innovations in Fatigue Risk Management Systems

Friday, 22 February 2019: 11:20 AM

Barbara J. Pinekenstein, DNP, RN-BC, FAAN
School of Nursing, University of WIsconsin- Madison, School of Nursing, Madison, WI, USA
Linsey M. Steege, PhD
School of Nursing, University of Wisconsin - Madison, Madison, WI, USA

Occupational fatigue in healthcare is a significant issue that affects nurse, patient, and organizational outcomes and often impacts nurse well-being (Smith-Miller, Shaw-Kokot, Curro, & Jones, 2014). Research has indicated that the prevalence of both acute and chronic fatigue is a challenge for both staff nurses and nursing leaders (Smith- Miller et al., 2014; Steege & Dykstra, 2016; Steege, Pinekenstein, Rainbow & Knudsen, 2017a). A more comprehensive approach to addressing occupational fatigue in healthcare systems is essential to strengthen healthy work environments and to achieve safety and quality in healthcare.

Current national guidelines and position statements released by a number of professional organizations often address the joint responsibility of the individual nurse and the organization to implement strategies to decrease fatigue (ANA, 2014; Caruso et al., 2017). Across industries including aviation, transportation and healthcare, there has been an increased emphasis on design, development, and implementation of fatigue monitoring and risk management systems; however, the adoption and implementation of fatigue risk management systems in healthcare organizations and nursing work systems specifically is limited (Steege, Pinekenstein, Rainbow, & Knudsen, 2017b). A recent exploratory mixed-methods study indicated that there was minimal adoption of evidence-based policies to address fatigue with some variability noted based on the policy type. In addition, although nursing leadership was aware of the importance and consequences of fatigue, nurse leaders reported mixed perceptions of hospital administrators’ awareness and priority need to address fatigue. Challenges with data monitoring, lack of decision support tools and limited implementation of evidence-based policies to address fatigue were identified as barriers to implementation (Steege et al., 2017 b).

Nursing work systems are dynamic and complex and as a result, innovations to remove barriers and increase the adoption of fatigue management systems is critical to promote healthy work environments. This session highlights the importance of establishing an infrastructure to support adoption of fatigue risk management systems. Resources include an organizational gap assessment and evidence-based tool kit. Key components of a multilevel risk management system including the importance of collaboration with human factors engineers are highlighted.

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