Fatigue related to long hours and poor sleep is common in nurses and can be hazardous to their health as well as to that of their patients. Scott and colleagues examined the effectiveness of a fatigue countermeasures program for nurses in decreasing fatigue in full-time nurses on medical-surgical units at three Michigan hospitals. The intervention included education on fatigue and loss of sleep, provided strategies for increasing the quality of sleep and staying alert, and discussed modifying the scheduling of shifts. Nurses were told to nap before long shifts, use days off to rest, and decrease sleep loss, as well as to use therapeutic caffeine, physical activity, naps, and breaks as needed during work hours. Hospitals were required to ensure that nurses could take breaks and sleep on duty during rest or meal breaks.

Of the 147 eligible nurses, 47 completed the trial. Data were collected for two weeks before the intervention (baseline), during the four-week period immediately after the intervention, and again at 12 weeks after the intervention. Nurses' sleep significantly increased from a mean of 7.83 hours a night at baseline to 8.59 hours during the four-week period and to 8.08 at 12 weeks after the intervention. Similarly, sleep quality improved, particularly at 12 weeks after the intervention. Although overall daytime sleepiness didn't improve, the proportion of nurses with severe or pathologic daytime tiredness decreased. Drowsiness episodes decreased from 88 at baseline to 31 during the four-week period and to 15 at 12 weeks after the intervention. In addition, drowsy driving decreased by 20% and 27% from baseline to the four-week period and to 12 weeks after the intervention, respectively. Notably, the decreased fatigue and improved sleep led to decreased errors made by nursing staff.

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