Fatigue in nurses and medication administration errors: A scoping review

Area of Science:

• Nursing Science
• Patient Safety Research
• Healthcare Management

Background:

• Medication administration errors (MAEs) result in preventable patient harm and substantial healthcare costs.
• Nurse fatigue is an emerging and significant factor contributing to MAEs.
• Understanding fatigue's impact on medication administration is vital due to its frequency as a nursing task.

Purpose of the Study:

• To systematically review the existing evidence on the effect of nurse fatigue on medication administration errors and near misses.
• Focus on registered nurses working within hospital environments.

Main Methods:

• A scoping review guided by the Arksey and O'Malley framework.
• Data extraction and analysis using the PAGER framework.
• Searched four databases (CINAHL, PubMed, Scopus, PsycINFO) for peer-reviewed English articles without date restrictions, focusing on nurses, MAEs, and fatigue/work hours.

Main Results:

• Eighty-two percent of the 38 included studies identified fatigue as a factor in MAEs and near misses.
• Fatigue is linked to diminished cognitive function, attention, vigilance, and overall nursing performance, impacting patient safety.
• Shift work components like circadian rhythm disruption and overtime were identified as contributors, though fatigue measurement methods varied significantly.

Conclusions:

• Nurse fatigue, influenced by factors like night shifts and overtime, negatively affects performance in medication administration.
• The heterogeneity in findings suggests a need for larger studies, particularly on overtime's impact.
• Re-evaluation of safe working hour policies and implementation of fatigue management systems are recommended for safe patient care.