Data-Driven Scheduling Strategies to Minimize Fatigue in Rotating Night-Shift Nurses

Area of Science:

• Nursing Science
• Occupational Health
• Sleep Medicine

Background:

• Shift work is crucial for healthcare but disrupts circadian rhythms, increasing nurse fatigue, burnout, and error risk.
• Current guidelines for managing nurse fatigue are often too general and lack specific strategies for scheduling and staffing.

Purpose of the Study:

• To identify optimal shift patterns and sleep-wake schedules for rotating night-shift nurses to minimize fatigue.
• To provide actionable recommendations for nursing management using mathematical modeling.

Main Methods:

• A quantitative observational study involving 273 nurses across three Korean hospitals using 8-hour rotating shifts.
• Sleep was monitored for 14 days using wearable devices, with data supplemented by surveys.
• Fatigue was assessed using a validated mathematical model (two-process model of sleep regulation) and simulations of alternative schedules.

Main Results:

• Night shifts led to the shortest sleep (5.0 hours) and highest fatigue, with over half of work hours spent fatigued.
• Three consecutive day/evening shifts resulted in the best outcomes (over 26 hours sleep, <1 hour fatigue).
• Consecutive night shifts and "quick return" patterns (<11 hours between shifts) significantly increased fatigue.

Conclusions:

• Reducing consecutive night shifts, avoiding quick returns, and promoting specific sleep routines can decrease nurse fatigue.
• Findings offer evidence-based guidance for roster design, policy development, and staff education to improve nurse well-being and patient safety.