Survey: Nurse understaffing, fatigue threatens patient safety

Fatigue leaves a majority of nurses concerned about their ability to perform safely, with two-thirds of nurses reporting they had nearly made a mistake at work because of fatigue and more than a quarter saying they had made a fatigue-related error, according to a survey commissioned by Kronos Incorporated.

The "Nurse Staffing Strategy,"  released this week at the American Organization of Nurse Executives conference in Denver, found nurse fatigue also can negatively affect operational costs, as well as patient and employee satisfaction, according to the research announcement.

Among the findings:

  • 39 percent of respondents found current staffing levels inadequate, while 38 percent found them unsatisfactory

  • 57 percent said workloads were not distributed evenly in the previous year, with 54 percent saying they had an excessive workload

  • 77 percent said their organization had 12-hour nursing shifts

  • 96 percent reported feeling tired at the beginning of their shift, and 92 percent while driving home after work

  • 63 percent said vacancies affected scheduling and overtime staffing "more often than anticipated"

  • 56 percent said their hospitals disregard required rest periods, and 65 percent said their hospitals do not have policies regarding cumulative days of extended shifts

Separate research recently published in JAMA Pediatrics found that nurse understaffing in neonatal intensive care units (NICU) leads to higher infection rates among very low-birth-weight babies.

Meanwhile, Democratic lawmakers in Michigan are joining a nurses' union in calling for a state law requiring hospitals to maintain lower nurse-to-patient ratios so they are adequately staffed without mandatory overtime, Michigan Radio reported.

Sixteen states have rules regarding staff-to-patient ratios, but California is the only  state setting minimum hospital staffing levels, according to the report.

"I don't think people realize that when your nurse is handling far too many patients, or working a double-shift or been mandated to stay over, it's probably because the hospital wants it that way," Scott Nesbit, R.N., told Michigan Radio.

The Michigan Health and Hospitals Association opposes the legislation, according to the report.

The nurse staffing survey was conducted by HealthLeaders Media and involved 120 completed surveys, with a margin of error of +/-8.9 percent at the 95 percent confidence interval.

To learn more:
- read the survey findings
- here's the Michigan Radio report