Relational Care Practice Model
C. Monique McFerrin, MSN, RN, CEN University of Texas at Austin School of Nursing DNP Student
Introduction:
Workplace fatigue is prevalent amongst acute care nursing staff
and is widely documented,2,3,4,5,6,7,8,9,10
Over 1 million nurses working in acute care work 12-hour shifts7
Odds of experiencing workplace fatigue is significant
Extended work hours, turnaround rotations, flex-scheduling, and
rotating shifts impact individual levels of fatigue1,11
Background:
Research indicates that nurses working successive 12-hour
shifts achieve inadequate sleep between shifts to recover both
physically and mentally6
65% of acute care nurses experience acute fatigue (AF) in the
workplace and 50% experience chronic fatigue (CF)1
The relationship between nurses working additional hours over
and above scheduled hours increases the risk of error by 1.5-3
times11,12
Practice Model: Implications for Practice::
There is not a place for fatigue in the workplace
Any distraction from nursing performance calls for employer and
employee intervention to deter any potential for patient harm
Recommendations for fatigue countermeasures include:
Limiting hours worked per week
Limiting the number of consecutive 12-hr shifts worked
Clinical Question: Limiting overtime hours
Offering 8-hour shifts instead of 12-hour shifts
Requiring a minimum of 7-hrs rest in between shifts
PICO Question - Whats the problem? Planning for staff having planned, uninterrupted breaks
Napping breaks during shifts
What is the prevalence of workplace fatigue in nursing staff to
Dedicated shift schedules (i.e. no rotating shifts)
develop fatigue countermeasures in an acute care hospital?
Staff education on achieving a healthy work-life balance
Conclusion:
Workplace fatigue is prevalent in acute care nursing
Nursing leaders are responsible for building healthy and safe
healthcare environments4,13,14,16
Fatigue management is a joint responsibility of nursing
employers and nursing staff
Nursing staff want to be a part of addressing the effects of fatigue
and need increased awareness of recognizing the presence of
fatigue, the effects of fatigue, and fatigue countermeasures9
utexas.edu/nursing