Investigating the Effect of a Fatigue Management Program on Daytime Alertness among Emergency Nurses: An Interventional Study

Abstract

Background and Objective: Shift work can lead to irregular circadian rhythms, sleep loss, and fatigue. This study aimed to determine the effect of a fatigue management program on the alertness of emergency nurses.
Materials and Methods: This quasi-experimental study was conducted among emergency nurses at an educational hospital in Mashhad City, Iran. All participants completed the Depression, Anxiety, and Stress Scale (DASS), the Karolinska Sleepiness Scale (KSS), and the Swedish Occupational Fatigue Inventory (SOFI), and underwent the Psy-chomotor Vigilance Test (PVT) before and after the intervention. The intervention included optimizing the shift schedule to a fast-rotating clockwise system with one day off after each night shift. In a one-day pre-intervention workshop, nurses were trained to take 2-hour naps during the night shift and to drink coffee at a recommended dose equivalent to 50-150 mg of caffeine. Environmental light exposure was optimized using an adjustable light box. Data were analysed using SPSS software.
Results: The study cohort comprised 25 participants, with a mean age of 30.88 ± 5.75 years, of whom 16(64%) were men. Two dimensions of SOFI (indifferent and uninterested) showed a significant improvement after the intervention (P = 0.027 and P = 0.016, respectively). The mean reaction time on the PVT did not differ significantly before and after the intervention (P = 0.70).
Conclusion: Optimizing the shift schedule and implementing a fatigue management program alone did not significantly improve alertness. Other contributing factors, such as sleep-wake behavior on non-working days, second-job status, and personal habits, should also be addressed.