Chronotype in Nurses: Fatigue and Patient Safety

Lauren E. Geerling

doi:10.7273/000003764

Chronotype refers to the tendency of an individual to be more alert during particular times of the day, and more fatigued at other times of the day. Chronotype can be broken down into three main categories, including morning, evening, and intermediate types. Based on the sleep patterns, periods of alertness and restfulness, and numerous other lifestyle factors, a particular individual’s chronotype can be established. This information is useful in determining when an individual may feel more fatigued or more alert. For instance, a morning-type person will often feel more alert in the morning, and fatigued at night. If a nurse is attempting to complete a task when they are fatigued, they are more prone to error. In turn, this can lead to safety issues for both the nurse and patient. The ability to determine chronotype is particularly important for shift workers. If a morning-type is assigned to night or rotating shifts, they may feel less well-rested, and work performance can decrease. Despite research regarding chronotype and shift-work performance, numerous health care agencies do not take this information into account when assigning nurses to particular shifts. When a nurse is not assigned to a shift consistent with their perceived chronotype, this can lead to an increased propensity to develop depression or a chronic disease, and an increase in patient safety issues such as medication calculation errors and needlestick injuries. Therefore, it is crucial to determine an individual’s chronotype for all-around safety. To address this issue, a survey was conducted to determine the chronotypes of nurses that were part of a previous study. The goal of the survey was to determine the chronotypes of these participants by utilizing the MEQ. Participants of the survey included 26 nurses: 1 scored as a morning type (3.8%), 12 scored as intermediate types (46.2%), and 13 scored as evening types (50.0%). This information was further utilized to determine if shift assignment was correlated with chronotype. For the one participant that had a perceived morning-type, this individual was assigned to day shift. 8 out of 12 (66.7%) of the perceived intermediate-types were assigned to day shift, with the remainder assigned to night shift (33.3%). Of the 13 participants who had a perceived evening-type, 12 were assigned to night shift (92.3%). Thus, it appears as though the shifts these nurses are assigned to are consistent with their perceived chronotypes. Furthermore, the more swayed towards “eveningness” on the scale a participant was, the higher the total score on the medication calculation test (p = 0.17). Therefore, since most participants have a perceived evening-type chronotype and are assigned to night shift, their overall shift performance is expected to be better than the individuals whose shifts are not correlated with their chronotype.

Chronotype in Nurses: Fatigue and Patient Safety

Files and links (1)

Abstract

Metrics

Details