High prevalence of nurse fatigue

1.Present the nursing practice problem with the PICOT
question.

2.Discuss your appraisal of the literature that addresses the
problem.

3.Present the proposed practice changes from an integration
of the findings.

Introduction

High prevalence of nurse fatigue and its detrimental
effects have been documented,

Critical analysis of Chen et al., 2014; Martin, 2015;
Hunsaker, Maughan and Heaston, 2015; Barbara, 2014;
Domen, Connelly and Spence, 2015; Stewart and Terry,
2014 identifies six areas for potential nurse fatigue,
burnout and possible strategies

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#

Author(s)

Year

Dependent Variables

Independent
Variables

Research Design

Data Collection
Method

Conclusion

Martin, DM. (2015). Nurse fatigue and shift
length: A pilot study. Nursing economics 33:2;
81-90

2015

Nurse experience,
length of shift,

Age, gender, ethnic
group

Randomized
controlled study

Qualitative and
quantitative

Study concluded that one of the interventions that
can be used to address nurse fatigue is by reducing
the nursing shift to 8 hour.

Hunsaker, S., Chen, H., Maughan, D and
Heaston, S. (2015). Factors that influence the
development of compassion fatigue, burnout and
compassion satisfaction in emergency
department nurse. Journal of Nursing
Scholarship, 47:2, 186–194.

2015

Organization culture
of the hospital, length
of shift, nurse
experiences

Age, gender, ethnic
group

Descriptive
quantitative
research method

Quantitative

Study concluded that low levels of support from the
nurse managers and long working hours are the main
cause of nurse fatigue. Study suggests that
developing protocols that improve identification of
compassion fatigue will help prevent emotional
exhaustion and facilitate the identification of
interventions to reduce nurse fatigue

Domen, R., Connelly, C., and Spence, D. (2015).
Call shift fatigue and use of countermeasures
and avoidance strategies by certified Registered
Nurse Anesthetists: A National survey. AANA
Journal 83: 2, 123-133

2015

Organization culture
of the hospital, length
of shift, nurse
experiences

Age, gender, ethnic
group

Systematic
review

Qualitative and
quantitative

The study concluded that call shift fatigue is
common issue among the CRNAs and is closely
correlated with patient safety and negative health
outcomes. The study recommends the identification
of the CRNA call-shift frequency and length.

Chen J., Davis K.G., Daraiseh N.M., Pan W. &
Davis L.S. (2014). Fatigue and recovery in
12-hour dayshift hospital nurses Journal of
Nursing

Management 22, 593–603.

2014

Nurse experience,
length of shift,

Age, gender, ethnic
group

Integrated review
on cross sectional
survey

Qualitative and
quantitative

The paper concludes that despite the widespread
acceptance of the 12 hour shift, the study concludes
that the nurse experience more fatigue. Additionally,
lacks of regular exercises are associated with
unhealthy fatigue recovery process. The study
concludes that the administrations, the staff and unit
managers must collaborate to attain healthy fatigue
recovery for the 12-hour shift.

Stewart, W., and Terry, L. (2014). Reducing
burnout in nurses and care workers in secure in
settings. Nursing standard 28, 34, 37-45.

2014

Nurse experience,
length of shift,

Ethnic group, location,
age

Systematic
review

Qualitative and
quantitative

The study suggests that clinical supervision as well
as the psychological intervention nurse training are
effective in reduction of fatigue and nurse burnout.
The study also concluded by stating that supportive
relationship effectively facilitates reduction of
emotional stress and nurse fatigue.

Barbara, H. (2014). Nursing Burnout
interventions; What is being done? Clinical
Journal of Oncology Nursing • Volume 18,
Number 2

2014

Nurse experience,
length of shift

Ethnic group, location,
age

Systematic
review

Qualitative and
quantitative

The study concludes that nurse fatigue and burn out
can be reduced through employee assistance
programs, retreats, promote stress reduction
program, improving relaxation as well as family
relationships and support of effective
communication to help the nurses cope with difficult
emotions.

Work load

Total quantity of work completed in a day, rate of
participating on unexpected events. Causes nurses to

Feel drained physically and emotionally

Lonely and skip lunches and breaks

Interventions

Taking five minutes break walk outside at least
twice
daily

Increase teamwork

Introduction of technology to reduce workload

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Control

Control :Participating in decision making processes, type
of leadership which causes the nurses

Feel hopeless or powerless especially In case of
death
of a patient

Interventions

Offering staff support

Providing on-site counsellors

psychiatric advanced practice nurses

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Reward

Nurse fatigue has been associated with forgoing nurse
cost-of-living raise due to organizational cost cutting

This leads to nurses holding onto anger and resentment

Effective implementation of clinical ladder programs that
provide salary increases is recommended

Recognizing achievements as well as opportunities for
bonuses or raises empowers the employee

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Summary of the interventions

Increasing frequency of supportive work interactions

Introduce technology 8-hour shifts to reduce work load

Encouraging staff to air their voices and respecting other
staff feelings

Encourage management education

Provide an annual retreat for staff

Designating team leaders for projects

Include self-evaluations in annual performance reviews

Encouraging expressive patient and staff therapies

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References

Barbara, H. (2014). Nursing Burnout interventions; What
is being done? Clinical Journal of Oncology Nursing •
Volume 18, Number 2

Domen, R., Connelly, C., and Spence, D. (2015). Call
shift fatigue and use of countermeasures and avoidance
strategies by certified Registered Nurse Anesthetists: A
National survey. AANA Journal 83: 2, 123-133

Hunsaker, S., Chen, H., Maughan, D and Heaston, S.
(2015). Factors that influence the development of
compassion fatigue, burnout and compassion satisfaction
in emergency department nurse. Journal of Nursing
Scholarship, 47:2, 186–194.

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