Examining Adverse Patient Outcomes in Nurses: The Role of Patient Acuity, Shift and Fatigue

This study identified key factors contributing to adverse patient outcomes (APOs) at a mid-western hospital. Understanding risk factors that contribute to increased nurse fatigue can provide solutions to reduce the impact that fatigue has on nurse performance and patient outcome. This study was comprised of two phases: 1) a database analysis of current data collected at a mid-western hospital, and 2) three focus groups to identify nurse perceptions pertaining to task demand and fatigue. The APOs analyzed in this study were medical administration errors (MAEs) and patient falls. A comparison of the data from both phases was then conducted to determine whether data reflected in the database correlated with nurse perceptions. This analysis documents significant results with respect to APOs in the following workload factors such as: hours worked, case mix index (CMI), shift, and nursing unit type.

Nurse Fatigue and Nurse, Patient Safety, and Organizational Outcomes: A Systematic Review

Hospital nurses are at high risk of fatigue due to stressful work environments with heavy workloads and non-standard work schedules. This systematic review examined the relationship between hospital nurse fatigue and outcomes. Full-text English language quantitative studies published between January 2000 and July 2020 were included. A total of 22 articles were reviewed and synthesized. The findings were synthesized into three major categories: nurse outcomes, nurse-reported patient outcomes, and organizational outcomes. Some of the most commonly studied outcomes include nursing performance (n=3), sickness absence (n=3), and intention to leave (n=4). Fatigue was consistently associated with mental health problems, decreased nursing performance, and sickness absence. Many studies confirmed that nurse fatigue is negatively associated with nurse, patient-safety, and organizational outcomes. However, our findings highlight gaps in current knowledge and the need for future research using a longitudinal design and measuring additional outcomes to better understand the consequences of nurse fatigue.

The Affecting Factors of Nurse Fatigue in The ICU and ER of Bhayangkara HS. Samsoeri Mertojoso Hospital

Introduction: Nurses have a very stressful job because they are required to deal with the needs of patients. Nurses are responsible for contacting and observing patients 24 hours a day. The nurse fatigue is associated with stress at work, workload, and the level of conflicts that occurs in the work environment. This research aims to analyze the relationship between the individual characteristics and fatigue of nurses’ performance in the ICU and ER. Methods: This research is observational research with a cross-sectional design and the analysis used in this study is a descriptive analysis conducted in the form of frequency tables and cross tabulations. The research data were obtained from filling in identity data sheets, IFRS work fatigue measurement questionnaires, and calorimeter measurements. To analyze the relationship between two variables with ordinal and nominal data scales including non-parametric statistics and due to the total population in this study, to find out how strong the relationship value is the Cramer V value in the Chi Square Test. The sample used was 25 nurses who work in the ICU and ER. Results: There is a relationship on the characteristics of nurses in the study which includes age, sex, length of service, education level, marital status, nutritional status, length of work, workload with subjective fatigue in ICU and ER nurses. Conclusion: In the test results obtained varying results from strong to weak relationship. In conclusion, individual characteristics cause subjective fatigue in ICU and ER nurses.Keywords: emergency room, intensive care unit, nurses, subjective fatigue

Nurse Health, Work Environment, Presenteeism and Patient Safety

Presenteeism is linked to negative outcomes for patients, nurses, and health care organizations; however, we lack understanding of the relationships between nurse fatigue, burnout, psychological well-being, team vitality, presenteeism, and patient safety in nursing. Therefore, the two aims of this study were: (a) to examine the fit of a literature-derived model of the relationships between presenteeism, psychological health and well-being, fatigue, burnout, team vitality, and patient safety; and (b) to examine the role of presenteeism as a mediator between patient safety and the other model variables. Survey data were analyzed using Composite Indicator Structural Equation (CISE) modeling, a type of structural equation modeling. Model fit was acceptable with multiple significant relationships. Presenteeism due to job-stress mediated multiple relationships to patient safety. Our findings indicate that focusing on job-stress presenteeism may be relevant for this population and may offer additional insight into factors contributing to decreased nurse performance and the resulting risks to patient safety.