Staff Nurse Fatigue and Patient Safety

说明(应用摘要)：立法强制限制 护士加班问题目前正在14个州立法机构待决。没有人知道如果 这项立法是为了保护患者的安全，或者如果它是一个副产品 医院护士对工作条件的不满。自.以来 注册护士不受联邦工资和工时法律的约束 加班费，人们对医院护士的工作时间知之甚少 以及延长工作班次对病人护理的影响。 研究一再表明，当出现以下情况时，生产率会降低，错误会增加 工人长时间工作和/或在夜间工作。人们对此知之甚少 护士每小时工作8小时以上对病人安全的影响 换档。夜间病人的安全尤其令人担忧，因为至少有三个 小规模研究表明，大约四分之一的护士工作 轮值或直接上夜班的人报告说，在照顾他人的同时努力保持清醒 对病人来说。 因此，这项研究将解决工作人员护士疲劳和患者安全问题 两种方式。第一阶段的研究将集中在描述工作时间 护士的工作时间和这些时间对患者安全的影响1) 用小时数描述医院护理人员的工作模式 工作时间、轮班时间和加班量；2)确定如何 有多少加班护士在加班，他们加班的频率是多少，什么时候 超时发生(时间)，以及护士是否需要加班；以及3) 确定错误与以下人员的工作时间之间是否存在关联 医院护士。第二阶段将涉及设计和测试 护士疲劳对策计划。这项对策计划将 涉及其他行业为将不利影响降至最低而采用的策略 疲劳、失眠和昼夜节律紊乱，并将进行评估 通过测试前和测试后的警觉性和睡眠/觉醒模式。

DESCRIPTION (APPLICATION ABSTRACT): Legislation to restrict mandatory overtime for nurses in now pending in 14 State legislatures. No one knows if this legislation is needed to protect patient safety or if it is an outgrowth of hospital nurses' dissatisfaction with their working conditions. Since registered nurses are exempt from the federal wage and hour laws governing overtime pay, little is known about the hours worked by hospital staff nurses and the effect of extended work shifts on patient care. Studies have repeatedly shown decreased productivity and increased errors when workers work for prolonged periods and/or at night. Little is known about the effects on patient safety when nurses work for more than eight hours per shift. Patient safety at night is of particular concern, since at least three small studies have shown that approximately one-fourth of nurses working rotating or straight night shifts report struggling to stay awake while caring for patients. Therefore, this study will address staff nurse fatigue and patient safety in two ways. The first phase of the study will focus on describing the hours worked by nurses and the effects of these hours on patient safety by 1) describing the work patterns of hospital staff nurses in terms of hours worked, duration of shifts, and amount of overtime worked; 2) determining how much overtime nurses are working, how often they work overtime, when the overtime occurs (time), and if nurses are required to work overtime; and 3) determining if there is an association between errors and the hours worked by hospital nurses. The second phase will involve designing and testing a fatigue countermeasures program for nurses. This countermeasures program will involved strategies used by other industries to minimize the adverse effects of fatigue, sleep loss, and circadian rhythm disruption, and will be evaluated by pre- and post-test measurements of vigilance and sleep/wake patterns.