Work Hours, Workload, and Fatigue in Nurse Anesthetists

Abstract

Fatigue is a factor in human error particularly on tasks requiring sustained attention (Dinges, 1995). Work-hour studies of staff nurses have demonstrated that the risks of making an error increased when nurses worked longer shifts (Rogers, Hwang, Scott, Aiken, and Dinges, 2004. Workload in anesthesia care can vary widely with diverse cognitive and physical demands (Gaba and Lee, 1990; Weinger, Herndon, Zornow, Paulus, Gaba, and Dallen, 1994; Weinger, Reddy, and Slagle, 2004; Weinger and Slagle 2001). The purpose of the study was to examine the influence of work hours and workload on fatigue in certified registered nurse anesthetists (CRNAs). A predictive, correlational design was employed and utilized an electronic survey of 10,000 active certified and active recertified CRNAs. A total of 928 CRNAs completed the survey which included a self-report of work hours. Workload was measured by the NASA Task Load Index and fatigue by the Checklist Individual Strength (CIS-20). Hierarchical multiple regression analysis was applied to the data to test the hypotheses that 1) after controlling for demographic variables, the number of work hours and workload will positively influence post-shift fatigue in nurse anesthetists and 2) after controlling for demographic variables, there will be an interaction between work hours and workload in nurse anesthetists. Work hours and workload explained 19 % of the variance in fatigue in nurse anesthetists with the greatest contribution being from the number of work hours and the workload dimension of performance satisfaction. The study findings suggest that increasing hours of anesthesia time and increasing workload, particularly dissatisfaction with meeting the goals of the anesthetic (performance dimension) increase fatigue in nurse anesthetists. The implications for practice, policy, and research are discussed.