Fatigue monitoring tool usage in operational paramedics

Objectives. Fatigue Monitoring Tools (FMTs) are one strategy employed to monitor and mitigate effects of fatigue in occupational settings. In ambulance services, these tools often involve simple, validated, rapid self-assessment instruments. This study reports on the frequency of FMT completion by paramedics, identifies their attitudes and perceptions towards these tools and examines how prevalent fatigue education is among paramedics. Methods. The study was a cross-sectional, online survey using validated instruments and open-ended questions which were analysed via descriptive statistics and content analysis. Paramedics were recruited through college membership, social media and study flyers. Results. Of the 223 participants, nearly all (85.0%) were found to infrequently use FMTs, with 76.8% reporting no FMT completion in the last 30 days. Non-completion was due to poor managerial response, poor fatigue safety culture, competing priorities at the start of a shift and perception the tool is not fit for purpose. Half of all participants had received fatigue education, but 79.4% felt they would benefit from further training. Conclusion. This study demonstrates low utilization rates of FMTs amongst paramedics due to varying, potentially preventable, organizational factors. Integration of fatigue education and streamlined fatigue management processes could promote fatigue safety culture within the paramedical setting.