Examining the Relationship Between Nurse Fatigue, Alertness, and Medication Errors

Area of Science:

• Nursing Science
• Occupational Health
• Patient Safety Research

Background:

• Nurses face occupational fatigue due to demanding work hours.
• Limited research exists on nurse fatigue, alertness changes during shifts, and their link to medication errors.

Purpose of the Study:

• To assess the relationship between nurse fatigue and alertness.
• To evaluate changes in nurse fatigue and alertness throughout shifts.
• To examine the connection between nurse fatigue, alertness, and medication errors/near misses.

Main Methods:

• Prospective study using a convenience sample of 90 nurses.
• Wearable actigraphy measured alertness; ecological momentary assessment (EMA) via text messaging measured fatigue.
• Data collected over 14 work and non-workdays.

Main Results:

• Increased fatigue correlated with decreased alertness (β = -1.06, p < .01).
• Night-shift nurses showed a 31-point alertness drop during their shift.
• Nurse fatigue, not alertness, was linked to medication errors and near misses (OR = 1.26, p = .01).

Conclusions:

• Mid-shift fatigue mitigation, especially for night-shift nurses, can reduce fatigue and improve alertness, enhancing patient safety.
• EMA-captured fatigue is a stronger predictor of medication errors than device-measured alertness.