0180 The Impact of Fatigue on Patient Care and Risk of Post-Shift Driving Collisions among 12-Hour Day and Night Shift Nurses

Abstract

Abstract Introduction Evidence across industries links work-related fatigue with errors, accidents, and adverse long-term health outcomes. Within the healthcare profession, 12-hour day and night shifts have been widely adopted for nurses, despite concerns about fatigue from these shifts affecting nursing performance and safety. The purpose of this study was to determine the impact of 12-hour day-vs-night-shift-accumulated fatigue on patient care and driving safety. Methods This between-groups, repeated-measures quasi-experiment was conducted in the Washington State University (WSU) College of Nursing and Sleep and Performance Research Center. 44 nurses working 12-hour day shifts and 49 nurses working 12-hour night shifts were recruited from Providence Medical Center. Participants reported to WSU for testing on two separate occasions—once immediately following their 3rd consecutive 12-hour shift and once on their 3rd consecutive day (72 hours) off work. Nurses' sleep was monitored using wrist actigraphy, and were tested for patient care using LAERDAL medical simulation, and driving safety using an immersive driving simulator. Results We found that both day and night shift nurses were significantly more sleep restricted and subjectively sleepy following three consecutive shifts. Night shift nurses were significantly more impaired on patient care skills, in particular the communication domain, compared to day shift nurses (who were largely able to maintain performance across all tests). Furthermore, night shift participants had significantly greater lane deviation during the post shift drive home, a key indicator of collision risk, demonstrating impaired driving safety. Conclusion This study provides objective evidence of the impact of shift work-related fatigue on patient and nurse safety, allowing us to make concrete recommendations regarding safe shift-scheduling for day and nightshift nurses—information that may help keep nurses safer and improve patient care. Support (if any)