While the number of medical errors occurring in Canadian hospitals may have fallen since 2004, there’s little doubt that officials should still be working to improve the standard of care provided to patients. And while hospital and nursing errors cannot be wiped out entirely, eliminating risk factors such as workplace fatigue could greatly improve the safety of Canadian healthcare facilities.
According to a Hospital News article published in January, 20 per cent of serious incidents and negative patient outcomes are related to fatigue. Nursing is an incredibly stressful and challenging profession, with heavy patient loads, extended shift work, and a constantly evolving field of practice making fatigue a chronic affliction.
A 2010 study of more than 7,000 registered nurses found that those working shifts of 12.5 hours or longer were three times more likely to commit a medical error. Overall, a fatigued worker is at a 70 per cent greater risk of committing an error than a rested worker, and studies have suggested that fatigue is four times more likely “to contribute to workplace impairment than drugs and alcohol,” according to Hospital News.
“You could be assisting a patient who is suffering from delusions and in the bed beside you another patient is dying,” Laura Istanboulian, a nurse practitioner at Michael Garron Hospital (MGH), told the Toronto Observer. “You have phones ringing off the hook, and might not even have eaten lunch that day.”
Istanboulian is far from alone: in the same 2010 study mentioned above, 80 per cent of the 7,000 nurses polled reported feeling tired at work, including 55 per cent who said they were “almost always” tired. Over the course of the 28-day study, every single nurse worked at least one overtime shift, and two out of three worked ten or more. Shift work, which the International Agency for Research on Cancer (IARC) has called “probably carcinogenic to humans,” has resulted in nurses reporting gaps in concentration, reduced situational awareness, and significant stress. In short, workplace fatigue in Canadian healthcare facilities has caused numerous hospital and nursing errors, and is a major health and safety issue.
Some groups, though, are taking steps to better understand fatigue in the workplace and formulate methods for preventing it. Ontario’s Public Services Health and Safety Association (PSHSA), for instance, is conducting a project alongside lead researcher Lora Cavuoto which uses Fatigue Science Readibands – a wearable technology – to monitor sleep, activity, and fatigue in participants.
“Today, we have little understanding of when and how fatigue intervention should be implemented,” said Cavuoto. “This research partnership with PSHSA will allow us to build first-of-its-kind fatigue interventions and customize them for particular industries, like healthcare, fire departments, police and mining to name a few.”
The research will be used to “evaluate the interaction of sleep-based fatigue and workload,” according to Hospital News.
At Michael Garron Hospital, a program aimed at raising awareness of mental fatigue was introduced in 2004. Intended to eliminate the stigma around mental health, the program offers meditation and group therapy sessions.
While limited-scale research and awareness programs like those undertaken by MGH and the PSHSA are positive steps towards mitigating the epidemic of hospital worker fatigue in Canada, more attention must be paid to the issue at all levels of government and hospital administration.
If you or a member of your family have been injured as a result of hospital and nursing errors, you should contact a member of the Medical Malpractice Group at Neinstein Personal Injury Lawyers. They can help you understand your potential for a claim and get you access to the resources you need to recover.