Medicolegal Issues

Shift Fatigue in Healthcare Workers


The Joint Commission in December issued a “Sentinel Event Alert” on the dangers of extended shift fatigue in healthcare workers, particularly for nurses who work shifts longer than 12.5 hours.1 A long list of potentially unsafe practices resulting from fatigue includes memory lapses, irritability, impaired communication, diminished reaction time, indifference, loss of empathy, and on-the-job injury.

The Joint Commission’s alert recommends practices to prevent negative effects from lack of sleep, including revisiting patient hand-off processes to maximize safety; giving staff a voice in their scheduling; educating employees about fatigue; and establishing a fatigue management plan and a forum for staff to discuss these issues. The American College of Graduate Medical Education’s current “Duty Hours Standards,” effective July 2011, require faculty members and residents to recognize the signs of fatigue and sleep deprivation and to adopt processes to manage the potential effects of fatigue on patient care.2


  1. Health care worker fatigue and patient safety. Joint Commission website. Available at: Accessed Jan. 10, 2012.
  2. Accreditation Council for Graduate Medical Education website. Available at: Accessed Jan. 10, 2012.

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