Associations of Insomnia, Fatigue, and Overtime Work With Self-Reported Medication Errors Among Perianesthesia...

To examine the associations of insomnia, fatigue, and overtime work with self-reported medication errors among perianesthesia nurses in South Korea.

Perianesthesia nurses perform high-risk medication tasks requiring sustained attention, but often experience insomnia, fatigue, and overtime that may impair cognitive performance. Their associations with medication errors remain understudied, particularly in South Korea.

A cross-sectional survey, reported following the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

We surveyed 213 perianesthesia nurses across South Korean hospitals. Insomnia and fatigue were measured with validated instruments, and participants reported recent overtime work and medication errors over the previous three months across twelve error types. Negative binomial regression examined associations, adjusting for demographic and work-related characteristics.

Clinically significant insomnia was present in one-quarter of nurses, fatigue in two-thirds, and recent overtime in four in five. In adjusted analysis, insomnia and fatigue were significantly associated with higher summed self-reported medication-error-type frequency scores, whereas overtime work was not. Estimates remained directionally consistent across sensitivity analyses, although the insomnia association was not significant when the outcome was dichotomized.

Clinically significant insomnia and fatigue were associated with a higher summed self-reported medication-error-type frequency score, whereas an association with overtime work was not supported. These potentially modifiable factors warrant further prospective investigation to determine whether addressing them improves medication safety in high-acuity perianesthesia settings.

Nurse managers may consider evaluating and implementing system-level strategies to monitor and mitigate fatigue and sleep disturbances among perianesthesia nurses to support medication safety and nurses' well-being.

Policymakers could support these organizational efforts by incorporating fatigue management into workforce and patient safety standards.