Reduction of Triage Nurse Fatigue Through the Implementation of an Evidence-Based Rotational Protocol

Emergency triage nurses frequently experience significant fatigue owing to long shifts, high patient volumes, and rapid decision-making demands. This chronic fatigue not only affects nurses' health and job satisfaction but also compromises patient care through increased risk of errors. This quality improvement project aimed to assess and address triage nurse fatigue by implementing a reduced shift length protocol at a single academic medical center.

Using the focus, analyze, develop, and execute model, this project compared fatigue levels during traditional 12-hour triage shifts with reduced 6-hour shifts. A Qualtrics-based pre- and postsurveys using the Samn-Perelli fatigue scale assessed self-reported fatigue levels among emergency triage nurses at 6- and 12-hour intervals. Surveys also captured demographic data including gender (man/woman), experience, education, and ethnicity. Preintervention data were collected over 34 days, followed by the implementation of a 6-hour rotational shift model.

Data analysis from 66 responses over 68 days revealed a statistically significant reduction in fatigue after the intervention. The average fatigue level decreased from 4.58 at the 12-hour mark before the intervention to 3.21 after the intervention (P = .02), representing a 29.91% overall reduction. Experienced nurses reported lower fatigue scores than less experienced peers, whereas nurses with bachelor's degrees demonstrated lower fatigue than those with associate degrees.

The implementation of shorter, 6-hour triage shifts effectively reduced fatigue among emergency triage nurses, highlighting a feasible strategy to improve nurse well-being, job retention, and patient care quality. Further projects should evaluate long-term outcomes and explore additional strategies to address nurse fatigue comprehensively.