The Hidden Cost of Fatigue in Health Care

tired nurse ebb sleep

As hospitals try to reduce costs, sleep-deprived nurses pose significant and often overlooked costs to workplace efficiency and patient care

Hospitals are losing more than an estimated $2.5 billion annually due to fatigue experienced by nurses nationwide. More than 1.6 million registered nurses[1] work in general medical or surgical hospitals throughout the U.S., and it’s estimated that over 477,000 of those nurses suffer from common sleep disorders including insomnia, obstructive sleep apnea, restless leg syndrome, and shift work disorder.[2]

Nurses are superheroes, selflessly attending to the care and needs of every patient–but even superheroes need sleep.

Fatigue in registered nurses, often caused by chronic sleep deprivation, is costing U.S. hospitals over $1 billion each year in decreased productivity based on calculations from the Real Costs of Fatigue in the Workplace. Additionally, hospitals lose another $530 million from absenteeism and another $916 million in annual healthcare costs. Untreated sleep disorders cost a company on average up to $3,500 per employee annually. By investing in sleep health education and sleep disorder screening programs, as well as cultivating a work culture that promotes healthy sleep for all employees, hospitals nationwide could potentially save more $1.2 billion each year and. More importantly, they could significantly improve the health and safety of nurses, and the quality of patient care.[3]

Sleep fatigue-related errors
The National Sleep Foundation recommends that adults each get 7-9 hours of sleep per 24-hour period. Nurses, like so many Americans, are shortchanging themselves, obtaining an average of just 6.8 hours per 24-hour period.[4] Losing a single hour of sleep per night can create significant sleep debt or fatigue over time, causing reduced vigilance and psychomotor coordination, slower reaction times and decision-making, and short-term memory loss.[5]

A 2012 study conducted by the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing found a third of registered Pennsylvania nurse participants reported suffering from high levels of burnout or fatigue, leading to avoidable medical errors and, in some cases, patient deaths. The results of the study demonstrated that a nurse’s work environment, along with staffing numbers, is directly correlated with the quality of patient care. The study recommends increasing staff numbers to reduce the nurse-to-patient ratios, however, another prevention strategy might be to propagate a work culture that promotes healthy sleep and implements tactics to ensure nurses are sleeping enough.

Less sleep = less work
Beyond detrimental errors caused by lack of zzz’s, sleep disorders and sleep deficiency can lead to significant absenteeism and presenteeism (a loss of a workday due to a lack of productivity by employees). In fact, the hospital industry loses an estimated 1.9 million days’ worth of work each year due to absenteeism by registered nurses, according to the NSC Real Fatigue Calculator. The rate of absenteeism is twice as much for night shift workers, who are already more vulnerable to sleep deficiency or a sleep disorder. Additionally, an estimated 5.6 million days’ worth of work per year is lost due to presenteeism by nurses at work. Employees with untreated insomnia are projected to be present, but not productive, for 10 full days on average each year.[6] These statistics are quantifiable reasons why the hospital industry–an industry dedicated to caring and improving the health of others–must focus on its own employees’ sleep health as well.

“Hospitals need to take steps to help with screening and identification of sleep disorders as well as train nurses and their managers on the risks of shift work and long work hours, and strategies to reduce these risks,” said Dr. Eric Nofzinger, founder of Ebb Therapeutics.

Sleep is good for business
Sleep health is not only good for an individual employee’s physical health and mental wellbeing, but also for business.[7] However, the unfortunate truth is that common sleep disorders like insomnia and shift work disorder often go undiagnosed and untreated.

Change is underway, but the costs of fatigue still have a significant impact on the hospital industry’s bottom line and on the quality of patient care. Hospitals, professional organizations, and employees should share responsibility for advocating and implementing sleep health programs for nurses, especially those working irregular hours. The costs of fatigue may be hidden, but they are all too real, and a good night’s sleep is critical for nurses to be fully prepared to continue serving as the superheroes they are.

This Ebb blog post and photo were republished with permission from Ebb Therapeutics. See their blog here.

[1] This excludes nurse anesthetists, nurse midwives, and nurse practitioners.

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