Improving management of staff fatigue during night shift: A collaborative whole team project Newcastle upon Tyne NHS Foundation Trust
- Led by the Department of Anaesthesia at Newcastle upon Tyne NHS Foundation Trust, in partnership with Northumbria University Newcastle.
- Co-designed a fatigue risk management strategy to help the labour ward team effectively manage night shift fatigue.
- Collaborative teamwork with participation from all staff groups of every grade meant the new fatigue strategies were quickly embedded into the labour ward culture.
Fatigue affects performance, with studies showing negative impacts on logical reasoning, vigilance, flexibility and empathy. In the NHS, fatigue can impact quality of care and patient safety.
In health care settings there is a lack of awareness of the significance of fatigue, a culture of tiredness being a weakness, and no clear fatigue management strategy. Other industries such as airline and petrochemical have fatigue risk management (FRM) systems that create cultures, processes, procedures and behaviours that prevent accidents.
This project aimed to establish a robust way of recognising, managing and minimising fatigue among midwives, nurses, doctors and health care assistants during night shifts on a labour ward at Newcastle upon Tyne NHS Foundation Trust.
The project involved innovative ‘action research’ methodology which used a bottom-up approach to designing the FRM strategies, with actions suggested by staff. In addition, 13 staff took part in a Fitbit study element of the project, which involved wearing a Fitbit linked to a specially designed app. Educational videos, posters and presentations heightened awareness.
The collaborative nature of the project meant that the new FRM strategies were quickly embedded and the labour ward culture moved to one where staff talk about their own fatigue and work as a team at night to ensure everyone gets a break.
Facilities have been set up for all staff to power nap in a quiet, dark, safe area during their break. Rota-making arrangements have changed so staff self-roster, choosing night shift patterns that better suit their sleep patterns. Managers now recognise when clinical errors or poor communication is related to staff tiredness, and doctors consider the safety of operating when they’ve been awake for many hours.
Contact information
For more information about this project, please contact:
- Dr Nancy Redfern, Consultant Anaesthetist, Newcastle upon Tyne NHS Foundation Trust
- Dr Alison Steven, Associate Professor, Northumbria University Newcastle
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