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Content Article
Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society (1 November 2021)
Patient-Safety-Learning posted an article in Workforce and resources
Regulators, organisations, communities and workers often struggle with how to manage shift duration and address associated risks from fatigue and sleepiness, while continuing to meet the societal demands for work. This article in the Journal of Clinical Sleep Medicine proposes a series of guiding principles help design a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.- Posted
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Content ArticleIn a series of blogs for the hub, we will be highlighting the impact fatigue has on staff and patients. In their first blog, Emma Plunkett and Nancy Redfern, part of the Joint Working Group on Fatigue, shared how they became involved in investigating night shift fatigue, setting up the Joint Working Group on Fatigue and the aims of the #FightFatigue campaign. In this second blog, Emma and Nancy are joined by Roopa McCrossan to highlight how tiredness can impact on our performance, the patient and staff implications of fatigue, and the actions that need to be taken not only at an organisational level to improve culture, but the effort required at national level too.
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Content ArticleThis presentation on fatigue and shift work is used as an induction session for doctors in training. It covers: Why are we talking about fatigue? What do you need to know? What can we do about fatigue? Improving sleep habits Working well at night How long to nap for Recovery after night shifts Driving tired Rest facilities Individual and organisational responsibilities and standards
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Content Article
Useful tips to aid sleep (Association of Anaesthetists)
Patient-Safety-Learning posted an article in Staff safety
This article by the Association of Anaesthetists offers guidance for healthcare workers on how to get a good sleep. It includes advice on the following techniques and ideas: Unchallenge your brain Have a hot bath Sleep in a way that works for you Be prepared Power napping tips- Posted
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Content Article
Poster - Working well at night (RCOA, 8 November 2018)
Patient-Safety-Learning posted an article in Staff safety
This poster by the Royal College of Anaesthetists, The Association of Anaesthetists and the Faculty of Intensive Care Medicine outlines practical principles for minimising the impact of fatigue for staff working night shifts. It includes tips for what to do before nights, during nights and between nights and advice on recovery after nights.- Posted
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Content ArticleThis presentation by the European Patient Safety Foundation (EPSF) outlines the issues associated with healthcare worker fatigue and highlights case studies of interventions to help fight fatigue in healthcare. It introduces the Fight Fatigue in Europe campaign and outlines its five-year action plan to #FightFatigue.
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Content ArticleHealthcare is a $4 trillion component of the US economy, and the well-being of the clinician workforce is a major factor determining its effectiveness. Extensive evidence indicates that inefficiency, poorly designed workflows and processes, suboptimal teamwork, work overload, isolation, problems with work-life integration, and a professional culture that expects perfection and discourages help-seeking are currently contributing to high levels of occupational distress among clinicians. Although the problem and its impact on the health care delivery system are well defined, there is minimal evidence regarding effective interventions to drive progress. This knowledge gap is, in large part, due to the near-complete absence of federal funding for research to address one of the critical challenges facing the US health care delivery system.
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Content ArticleIn a series of blogs for the hub, Emma Plunkett and Nancy Redfern, part of the Joint Working Group on Fatigue, will highlight the impact staff fatigue has not only on the staff themselves but also on patient safety, and why healthcare needs a robust fatigue risk management system like other safety-critical industries. In their first blog, Emma and Nancy share how they became involved in investigating night shift fatigue after the death of a colleague driving home tired. They discuss how they set up the Joint Working Group on Fatigue and the aims of the #FightFatigue campaign.
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Content ArticleThis is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Laura and Suzy talk to us about the importance of embedding human factors in the design of healthcare systems and tools, the importance of equipping staff to think about system safety, and their work to establish a nationwide conversation about the impact of fatigue.
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Content ArticleThis Patient Safety Advisory from the Pennsylvania Patient Safety Authority provides an overview of the issues associated with healthcare worker fatigue. It outlines fatigue risk mitigation practices that are being used in healthcare and other industries, including comprehensive fatigue risk management programs.
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Content ArticleWhen healthcare workers are fatigued, the safety of both patients and staff is compromised. This short article in the American Journal of Nursing reports on a recent webinar in which the Joint Commission distilled current research on fatigue, discussing its causes and symptoms and the various means of addressing the issue. Ann Scott Blouin, a nurse and Executive Vice President of Customer Relations at the Joint Commission, led the discussion and highlighted that factors contributing to staff fatigue fall into three categories: organisation and management issues, the nature of the work and personal challenges. Fatigue has emotional, physical, and behavioural consequences, including lapses in attention, diminished reaction time, and reduced motivation.
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Content ArticleNurses work long hours and play a critical role in keeping patients healthy. Many nurses feel that fatigue “comes with the territory” of such a high-stress, high-impact job. But what’s really at risk when a nurse is fatigued? This blog by US insurance company Nurses Service Organization (NSO) looks at the impact of nurse fatigue on patient and staff safety. It suggests several strategies to address the issue: Designing schedules and organising work to reduce nurse fatigue Developing a fatigue management plan Educating staff on sleep hygiene and the effects of fatigue on nurse health and patient safety Providing opportunities for staff to express concerns about fatigue and taking action to address those concerns Making sure extended shifts have adequate staff support and rest periods
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Content ArticleSentinel Event Alerts from the Joint Commission identify specific types of sentinel event (a patient safety event that results in death, permanent harm or severe temporary harm), describe their common underlying causes and suggest steps to prevent them occurring in the future. This Sentinel Event Alert looks at the well-documented link between health care worker fatigue and adverse events. It looks at: The impact of fatigue Contributing factors to fatigue and risks to patients Actions suggested by The Joint Commission for healthcare organisations
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- Fatigue / exhaustion
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Content ArticleFatigue in anaesthesia practice is often ignored or accepted as the norm due to persistent, high-intensity work demands and expectations. This document produced by the American Association of Nurse Anesthesiology (AANA) aims to provide guidance to healthcare professionals, healthcare facilities and nurse anaesthesia programs regarding sleep deprivation and fatigue. It provides evidence-based information that promotes fatigue management and work-life balance.
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Content ArticleThis brief paper reviews the available published literature on shiftwork and safety that allows the estimation of the relative risk of “accidents” or injuries associated with specific features of shift systems. It discusses three main trends in risk: Risk is higher on the night shift, and to a lesser extent the afternoon shift, than on the morning shift Risk increases over a span of shifts, especially so if they are night shifts Risk increases with increasing shift length over eight hours The authors discuss the fact that some of these trends are not entirely consistent with predictions made based on considerations of the circadian variations in sleep propensity or rated sleepiness, and consider factors relating to sleep that may underlie the observed trends in risk. They also discuss the practical implications of the trends in risk for the design of safer shift systems.
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Content ArticleFatigue is increasingly considered as one of the most significant hazards to aviation safety and other safety-critical industries. Both the academic community and industry have focused on understanding the phenomenon of fatigue and the factors that contribute to it in order to prevent it, but also to mitigate its possible consequences. As a result, procedures and regulations have been developed for operators to comply with and there is now a requirement for operators to demonstrate that they are actively managing fatigue. The aim of this white paper by Clockwork Research is to provide safety practitioners with a better understanding of the process of investigating fatigue.
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Content Article
Queensland Health: Fatigue risk management systems
Patient Safety Learning posted an article in Good practice
This guideline has been developed to support all Australia's Queensland Health workplaces to identify and manage fatigue risks. It draws on lessons learnt from over a decade of implementing fatigue risk management systems (FRMSs) in Queensland Hospital and Health Services (HHSs) and from proven approaches to safety risk management.- Posted
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Content ArticleThe guardian of safe working hours ensures that issues of compliance with safe working hours are addressed by the doctor and the employer or host organisation as appropriate. It provides assurance to the board of the employing organisation that doctors' working hours are safe. Access the resources that guardians of safe working hours will need in order to fulfil their roles. It includes, a job role specification, checklist of things to do, templates for annual reports and more.
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News Article
NHSE director demands maternity consultants work nights
Patient Safety Learning posted a news article in News
The deputy chair of NHS England has said it should be as ‘demanding’ of medical cover in obstetrics and neonatal care as it is for emergency departments, to improve safety in the wake of repeated care scandals. Sir Andrew Morris, who was the long-serving chief executive officer of the well-regarded Frimley Health Foundation Trust, said the service would “expect a consultant to be on duty in an emergency department [from] 8am till 10pm, or midnight, seven days a week”. Speaking at NHS England’s public board meeting yesterday, Sir Andrew said: “We haven’t set that similar expectation out for [maternity care]. I know we’re saying we’re expecting that two ward rounds are undertaken, each day, seven days a week, but that is very different to the service I think is appropriate for this type of semi-emergency operation, that most trusts run. “I’d like us to be as demanding of organisations [in relation to obstetrics and neonatal] as we are for the emergency department.” Read full story (paywalled) Source: HSJ, 1 December 2022- Posted
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News Article
NHSE director ‘shocked’ by lack of weekend working
Patient Safety Learning posted a news article in News
The national director for mental health has said she was shocked to discover how many ward managers do not work at weekends, adding this could contribute to abuse and poor care going undetected. Asked at the NHS Providers conference about recent reports into care scandals, NHS England’s director for mental health Claire Murdoch said it was crucial to listen to frontline staff, such as healthcare assistants, who spend most of their time with patients. But she added: “[It’s also] making sure your ward managers do work of a night and at the weekend. “I’ve been a bit shocked to hear that we’ve moved with agenda for change and quite often ward managers are Monday to Friday people.” Her comments come amid a string of high-profile care scandals, such as at the Edenfield Centre in Greater Manchester, as well as an ongoing debate around seven-day working across the NHS. It is understood Ms Murdoch is concerned managers are spending too much time on bureaucratic tasks, which typically happen during Monday to Friday shifts, meaning they are then not working night or weekend shifts. In September, the national director ordered all trusts to carry out safety reviews, warning in a letter they should leave “no stone unturned” in seeking to eradicate and prevent poor care. She also urged all boards to urgently review safeguarding of care in their organisations, and identify any immediate issues requiring action now. Read full story (paywalled) Source: HSJ, 15 November 2022- Posted
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News Article
NHS England urgently appeals to GPs to staff triage service
Patient Safety Learning posted a news article in News
A key element in the new covid-19 response service run by NHS 111 urgently needs more doctors, NHS England has said. The national covid-19 clinical assessment service, or CCAS, serves a cohort of patients with coronavirus symptoms deemed by 111 as needing a clinical assessment over the phone or online. An email to GPs from NHSE’s primary care directors on Friday evening said: “We urgently need more GPs help to staff this service, especially as covid-19 cases increase over coming days, because of your expertise and experience.” Read full story Source: HSJ, 6 April 2020- Posted
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Content ArticleThis systematic review in the BJGP aimed to review literature published up to December 2020 on the prevalence of burnout among GPs in general practice, and to determine GP burnout estimates worldwide. The review found: there is moderate to high GP burnout around the world. substantial variations in how burnout is defined, which has resulted in considerable variation in GP burnout prevalence estimates. that this variation presents a challenge in developing a uniform approach that considering GPs' work contexts will allow better understanding and definition of burnout.
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EventThis Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night, and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night and transforming out of hours services and roles to improve patient safety. The 2023 conference will focus on the developing an effective Hospital at Night service, and focus on the practicalities of supporting staff at night, improving wellbeing and fighting fatigue. Benefits of attending this conference will enable you to: Network with colleagues who are working to improve Hospital at Night Practice. Learn from recent developments. Improve your skills in the recognition management and escalation of deteriorating patients at night. Understand and evaluate different models for Hospital at Night. Examine the role of task management solutions for Hospital at Night, including handover and eObservations. Ensure effective and safe staffing at night. Improving and supporting the wellbeing of hospital at night staff. Examine Hospital at Night team roles, competence and improve team working. Improve safety through the reduction of falls at night. Supporting staff and reducing fatigue at night. Develop the role of Clinical Practitioner and Advanced Nursing Practice at night. Identify key strategies to change practice and ways of working in Hospital at Night. Understand how hospitals can improve conditions for night workers and support Junior Doctors. Self assess and reflect on your own practice. Supports CPD professional development and acts as revalidation evidence. This course provides 5 Hrs training for CPD subject to peer group approval for revalidation purposes. Register hub members receive a 20% discount. Email info@pslhub.org for discount code.
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Event
An enhancing junior doctors working lives (EJDWL) event
Sam posted an event in Community Calendar
An enhancing junior doctors working lives (EJDWL) event hosted by NHS England for: Doctors in training Guardians of Safeworking National guidance encourages the use of e-rostering for medics and it is increasingly likely that doctors in training will encounter an e-rota while working in secondary care. However, doctors’ knowledge of e-rostering is often limited to previous experience, which can make it difficult to know whether they are benefiting from all the features available. This lunchtime webinar aims to educate doctors on the range of features available, and empower them to engage with and improve e-rostering at their workplace. As well as an introductory talk from doctors in training in the EJDWL team, hear real world examples from doctors on how they have engaged with and improved e-rostering, and learn how you can do the same at your workplace and nationally. Speakers: Professor Robert Galloway - Helping to solve NHS challenges with a workforce first approachED consultant championing annualised rotas with self-preferencing, University Hospitals Sussex. Dr Daniel BarryAnaesthetic trainee and co-founder of dbrotas, Wessex School of Anaesthetics. Dr Mark Johnson - Personalised Pay - Proving the 'impossible' is possibleMedical registrar and Board Affiliate, championed personalised rotas and pay at Buckinghamshire Healthcare NHS Trust. Dr Nicholas Turner, Dr Jack Haywood, Dr Kavir MatharuNational Medical Director's Clinical Fellows EJDWL working group members. Register -
EventThis Hospital at Night Summit focuses on out of hours care in hospitals delivering high quality safe care at night, and supporting the wellbeing of those working at night. Through national updates, networking opportunities and case studies this conference provides a practical guide to delivering a high quality hospital at night and transforming out of hours services and roles to improve patient safety. The 2023 conference will focus on the developing an effective Hospital at Night service, and focus on the practicalities of supporting staff at night, improving wellbeing and fighting fatigue. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/hospital-at-night-summit or email frida@hc-uk.org.uk. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HospitalAtNight
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