Study aims to help hospital staff manage fatigue when working at night shifts

Hospital staff are set to benefit from a new study that aims to help them manage the tiredness and fatigue they experience when working night shifts.

The Health Foundation has awarded £56,000 to Northumbria University, Newcastle and the Newcastle upon Tyne Hospitals NHS Foundation Trust to find new ways to support staff working night shifts on the labour wards.

Many night shift staff report how fatigue can have an impact on how well they are able to do their job, as well as on their physical health and psychological wellbeing.

The researchers will work closely with midwives, doctors, nurses, operating department practitioners and healthcare assistants in the Royal Victoria Infirmary, exploring and testing better ways to help people to manage their sleep and fatigue during long night shifts.

Dr Nancy Redfern, Consultant Anaesthetist and project lead at Newcastle Hospitals said: "The labour ward can be a busy place at night, and however hard we try, tiredness affects everyone's performance. We hope that by using ideas from the whole team of midwives, nurses and doctors that we can develop a way of managing their night shift fatigue in a way that genuinely improves staff wellbeing and morale. It will be good for patients and good for the whole team."

The researchers will provide staff with wearable activity monitors and an app specially developed by Sleep and Fatigue Research to help people monitor their sleep wake patterns and predict how their fatigue will affect them over the next 20 hours.
They will also hold focus groups, interviews and ask staff to complete wellbeing questionnaires to understand people's experiences of night shift tiredness. It is hoped that solutions developed in partnership will improve team working at night and enable breaks and powernaps to be built into workers' schedules.

Dr Alison Steven, Reader in Health Professions Education in Northumbria University's Department of Nursing, Midwifery and Health, is leading the research team at Northumbria. She said: "This innovative action research project will enable both organisations and ward teams to work together using a participatory approach to co-design a new strategy to manage the risk of fatigue in theatre and obstetric teams. We hope that this approach may improve decision-making, the management of emergencies, patient and staff safety and staff morale."

Speaking about her own experiences of working nightshift, trainee anaesthetist Dr Roopa McCrossan said: "We work from 8.00pm to 8.30am on night shift. The nature of the job means taking breaks overnight can be difficult. As anaesthetists we deal with many unpredictable emergencies, such as trauma calls, cardiac arrest calls and urgent caesarean sections.

"This project has huge potential to improve staff and patient safety in the hospital overnight. Alerting clinical staff to when they are critically fatigued allows the whole team to take action. In the longer term, the project will allow us to modify rotas to shift patterns that are less likely to cause high levels of fatigue amongst staff."

Dr Kirstie Anderson, a sleep expert at the Newcastle Hospitals, is supporting the project. She said "All our staff need the best sleep possible to care for patients' day and night.

"Tiredness affects everyone's performance and can impact quality of care and patient safety. Our vigilance becomes more variable; we may be less good at logical reasoning, less empathetic and more prone to make errors. Other safety critical industries such as airlines, nuclear and petrochemical companies have formal fatigue risk management strategies - we need them in healthcare as well."

The funding has been awarded as part of The Health Foundation's Innovating for Improvement programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. Its Innovating for Improvement programme aims to improve the delivery of health and social care, as well as helping people to manage their own health care by redesigning processes and practices.

Sarah Henderson, Assistant Director of Improvement Programmes at The Health Foundation added: "We're excited to support this project - one of 23 that have been developed by frontline teams to improve health and social care across the UK. We are looking forward to working with the teams to develop their innovative ideas, put them into practice and gather evidence about how their projects are improving care for patients.

The project will run for 15 months from January 2019. It forms part of Northumbria University's research into integrated health and social care which explores new, sustainable and effective ways of promoting health and wellbeing across all age groups.