The Joint Commission has issued a new Sentinel Event Alert: Health care worker fatigue and patient safety alert that comes about over concerns for patient safety. Burnout and fatigue among health care employees should be addressed by employers according to the alert.
The alert also comes about because of concerns for the safety of nurses, physicians and other working in the health care field.
In November 2007, The Joint Commission Journal on Quality and Patient Safety reported nurses who work more than 12 hours are more likely to be injured.
Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., president, The Joint Commission says, “Health care is a round-the-clock job, and safety has to be the priority.”
The Joint Commission, which is an organization that provides hospital accreditation to hospitals based on a number of factors, has recommendations for healthcare facilities that they say should be implemented.
Among the recommendations is assessing staff for factors that could lead to fatigue, including off-shift risks, working consecutive shifts and staffing patterns.
The commission also recommends looking closely at change of shift when care is ‘handed-off’ to the next employee that might put patient safety at risk from employee fatigue.
Fatigue among healthcare workers can lead to inability to concentrate, confusion, irritability, impaired communication, slower reaction times, memory lapses and faulty judgment and processing.
“An overwhelming number of studies keep saying the same thing – once you pass a certain point, the risk of mistakes increases significantly,” says Ann Rogers, Ph.D., R.N., FAAN, a nationally renowned sleep medicine expert with Emory University’s Nell Hodgson Woodruff School of Nursing. “We have been slow to accept that we have physical limits and biologically we are not built to do the things we are trying to do.”
The joint commission recommends that employees be allowed to provide input in designing work schedules that minimize the potential for fatigue.
They also recommend employees in a Health Care setting should be educated about the importance of sleep hygiene.
Other strategy suggested are to allow employees adequate breaks that include physical activities such as stretching or engaging in conversations with others.
Tired healthcare employees are at risk for injury and put patients at risk. The Joint Commission also recommends that Health Care facilities that allow for sleep breaks ensure employees get quality sleep, adequate coverage for their responsibilities including handing off pagers and cell phones to a covering associate. You can read the entire alert here.
Christopher P. Landrigan, M.D., M.P.H., director of the Sleep and Patient Safety Program, Brigham and Women's Hospital and author of several research studies exploring the effects of provider sleep deprivation on patient and provider safety stresses the importance of reducing work hours for all health care workers. Landrigan says health care providers need to recognize their limits, in a culture that normally works long hours. He says, the “impact of fatigue has not been a part of our consciousness.”
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