Fatigue and Medication Errors – Care Example

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"Fatigue and Medication Errors" is a wonderful example of a paper on care. Many contemporary studies have revealed that long working hours have a negative impact on the performance of the staff of health care providers. Like in a survey conducted, 15 out of 3600 resident physicians who had been working for more than 80 hours a week reported that they experienced irritability and high fatigue leading to committing errors which were quite less in the case of those physicians who used to work less than 80 hours a week.   Critical care residents also made significant errors when their duty hours exceeded 16 hours especially in writing orders (Lockley et al.

2004). Significance Although it is not expected that health care providers would commit errors, however, mistakes occur and sometimes such mistakes lead to serious injury or loss of lives. Around 1.3 million patients get injured every year due to errors during hospitalization (Rogers, 2003). Similarly, around 100,000 people die every year because of such errors (Berenholtz et al. 2003). The impact of errors is greater for the patients who are in a state of urgency or in critical care units.

Such patients are in a state of a serious ailment and require additional attention and care and even minor negligence with such patients may result in a greater mishap.   Further, more than 30% of the nurses have shown that they struggle to awake at least once in four weeks. 33 Such a finding is similar to outcomes of the investigations of nurses that work in the traditional pattern of shifts, it was found that drowsiness episodes and impairment in alertness are not confined to the night shifts only when circumstances influence to make them awake for long hours. 14 In fact 29% of actual sleep and 47% of episodes of drowsiness occur between 6 am and midnight (Landrigan et al.

2004).     Outcome The health care units that deal with urgent cases and are located in the urban centers have to manage a greater number of patients and emergency cases. Therefore the nursing staffs are overburdened in such hospitals and critical care units and ultimately the ratio of committing errors and responding to the emergency (alertness) is compromised.

Understaffed hospitals demand more hours of work from the nurses and thus the fatigued routine and stress result in lowering of job performance. Especially emergency patients and urgent care are deeply affected because of long hours of work. Hence injuries, irreparable damage, and deaths occur due to mistakes which prompt to take corrective measures and remedial actions to overcome the issue.   Remedies In the short run, the appropriate remedies could be: Schedule Management Efficient management of the schedule of nurses may result in lowering work burden and long hours. Motivation Nurses should be motivated through rewards and recognition to take care of the patients with full dedication and commitment. Team Work Nurses should be encouraged to work in a team so the probability of errors may be lessened. While in the long run, appropriate remedies could be: Hospital Management Management of the hospitals should take this challenge and act positively towards the matter.

Strategic schedule and objective planning may reduce the stress. Staffing Understaffed hospitals should develop an appropriate ratio of nurses to patients and recruit the number of nurses required adequately. Infrastructure The improved infrastructure of the health units may bring in efficiency and eventually nurses may find it at ease to work.



Landrigan et al. (2004) Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med. 351:1838-1848.

Lockley et al. (2004) Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med.351: 1829-1837.

Berenholtz et al. (2003) Improving quality and safety in the ICU. Contemp Crit Care.1:1-8

Rogers et al. (2003) Hospital staff nurses regularly report fighting to stay awake on duty. Sleep.26(suppl): A424-A425.

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