The relationship between resident and physician duty hours and patient safety has been the focus of a lot of research. The relationship between nurse work schedules and patient safety is less explored. This review investigated the effect of extended or excessive nurse schedules on patient outcomes. Findings conclude that working more than 12 hours daily or more than 40 hours weekly may contribute to adverse patient outcomes. The authors recommend creating policies restricting nurse shifts to no more than 12 hours per day and 40 hours per week.
Leviatan I, Oberman B, Zimlichman E, et al. J Am Med Inform Assoc. 2021;28:1074-1080.
Human factors, such as cognitive load, are main contributors to prescribing errors. This study assessed the relationship between medication prescribing errors and a physician’s workload, successive work shifts, and prescribing experience. The researchers reviewed presumed medication errors flagged by a computerized decision support system (CDSS) in acute care settings (excluding intensive care units) and found that longer hours and less experience in prescribing specific medications increased the risk of prescribing errors.
Westbrook JI, Raban MZ, Walter SR, et al. BMJ Qual Saf. 2018;27:655-663.
This direct observation study of emergency physicians found that interruptions, multitasking, and poor sleep were associated with making more medication prescribing errors. These results add to the evidence that clinical environments prone to interruptions may pose a safety risk.
Intern J Health Care Qual Assur. 2007;20(7):555-632.
This special issue includes articles by authors from Australia, Israel, France, Iran, and Belgium that explore ideas such as building a culture of safety, replacing medical equipment, and measuring safety improvements.
The investigators surveyed nurses in one Japanese hospital. They found that workload and lack of experience may contribute to medical errors, whereas nurses who were more alert or had more experience were better able to detect near misses before they became errors.
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