To Err is human calls attention to the magnitude of the adverse effects occurring every day to the patients in the hospital. Reports estimate that adverse events in a frequency of 2.9% to 3.7% of the acute care hospitalization and half of these events are likely to be as a result of errors. Indeed, to Err Is Human comes up with an evidence that the presented figures are underestimates of the number of patients injured by critical incidents in health care. These figures do not also include the number of persons injured as a result of medical errors or critical incidents in nursing homes, home healthcare, and other healthcare settings. Other earlier studies of critical incidents and medical errors in healthcare units similarly indicated high rates of adverse events. This essay seeks to discuss a critical event resulting from fatigue of nurse and staff members which has been recognized as a significant threat to the safety of a patient. There has been a call by the risk managers to adopt different strategies of reducing fatigue which might be as a result of excessive workloads, overtime, and poor scheduling.
Description of the Critical Incident on Nursing Fatigue
Rogers (2016) notes that addressing fatigue in healthcare settings makes attention to go to physicians and other overworked medical residents. Fatigue stances a great risk to the safety of patients with the healthcare industry not being to understand how the pressures of clinic work can make nurses fatigued to a point to risking the safety of patients. Fatigue-related to nurses has raised a lot of concerns with researchers undertaking many studies to answer many questions raised. Bazazan et al. (2018) note that this becomes a threat as nurses are closely related to patients, and these fatigue-related incidents result into improper care to patients. There is a critical incident that occurred after handling daily eight- working hours shift on August 9 and offered to undertake an additional shift on that day. There was a scheduled shift on August 5th on the morning hours of 7 am, although a mistake occurred after providing “intravenous bupivacaine” to a 20- year old lady which was purposely to induce her from labor. The intended aesthetic for the administration of epidural had failed to be ordered. Although very confident in my reasoning, the prescription was “intravenous penicillin” to treat “streptococcal infection," and this led to the death of the lady from cardiac seizure. Applicable standards were upheld, and was charged with initial felony which is “a criminal neglect of a patient causing great bodily harm," but after adequate evidence was provided, there was a chance of pleading no contest. Although many people thought that the treatment had been incredibly unfair, the organization had suspended incentives offered for long- shifts, and this was supposed to bring intuitive signs for the happening of that incident thereby predicting the incident.
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Analysis and Reflection of the Critical Incident on Nurse Fatigue
Later, the organization’s risk manager confirmed that fatigue was the main cause of the critical incident, and therefore, it had to implement a strategy of limiting working hours. Naturally, Rogers (2016) notes that the problem is more serious and common in healthcare settings where patient care is provided 24 hours a day and, in the organization, where overtime is mandatory. Organizations are affected by the fatigue of nurses whether it is as a result work schedule which promotes risks from the attention lapsing, inability to focus, confusion, or even slow time for reaction. Numerous studies carried out reports there being an association between sleep in the 24 hours of service and the risk involved with patients’ safety. Other research has also brought forward the comparison of the impairment caused to the blood alcohol content with a suggestion that nurses active for service for 19 hours report a 0.05% blood content (Bazazan et al., 2018).
Preventing the Effects of Nursing Fatigue on Patient’s Safety
The key strategies that managers can take in averting the effects of nurses’ fatigue on patients' safety include coming up with schedules as well as ensuring that they organize work that will reduce nurse fatigue. Steege et al. (2017) note that the Joint Commission commends assessing of policies by healthcare facilities to ensure that they identify the risks which are related to fatigue of nurses. The managers are required to review their staffing for them to stress on the areas that might be the main contributors to nurses’ fatigue. Nurses who are exposed working conditions where they are on service for two consecutive 12 hours shifts suffers from the lack of sleep on the working days. This is a stance for a threat to patient care and their health as well as the well- being of the nurses. Steege et al. (2017) report nurses’ burnout as a result of fatigue which causes health issues. Nurses report their personal association disturbance which in turn affects their productivity negatively and increasing the negative insolences towards work. Nurses can also help to decrease their fatigue level by enhancing teamwork whereby they can support each other if by any case they must work extended shifts for them to practice good personal sleep habits.
The healthcare managers and leaders should identify the general impacts that extended working hours have a fatigue level of nurses before opting to employ extended assignment shifts in their organizations. It’s ultimately the responsibility of nurses to turn down the extended assignments in case they are fatigue impaired. It is also the role of the organization to keep communication lines between the organization management and the employees open to help encourage the solving of fatigue-related issues by nurses without fear of being reprised by the organization (Rogers, 2016). To prevent any form of patient injury, and nurses' fatigue, the healthcare organization’s management should ensure that they closely monitor nurses’ working hours. Nurses also need to be responsible and enhance teamwork, ensuring the capability of shift assignments acceptance. Development of fatigue management plans and also establishing safe schedules will be enhanced by the nurses becoming a proactive force.
Nursing profession turnover can be used to measure nurses’ fatigue and the threat that is imposed on the safety of patients. The risk managers should ensure that the hospital's nurse turnover rate becomes a better indicator of the happiness of nurses and reduce the effect of fatigue on job gratification. Inventive scheduling can significantly help in reducing nurses’ fatigue. Hospitals should avoid only relying on the traditional scheduling method. The overwhelming evidence on nurses working longer than 12 consecutive hours do not obtain sufficient sleep which put their health and that of patients to a risk. Nurses, the managers in healthcare organizations and other policymakers must work together to ensure that the culture of nurses to working extended hours is changed.
References
Bazazan, A., Dianat, I., Rastgoo, L., & Zandi, H. (2018). Relationships between dimensions of fatigue and psychological distress among public hospital nurses. Health promotion perspectives, 8(3), 195.
Rogers, A. E. (2016). The effects of fatigue and sleepiness on nurse performance and patient safety. In-Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US).
Steege, Linsey M., Barbara J. Pinekenstein, Jessica G. Rainbow, and Élise Arsenault Knudsen. "Addressing occupational fatigue in nurses: current state of fatigue risk management in hospitals, part 2." JONA: The Journal of Nursing Administration 47, no. 10 (2017): 484-490.
