Occupational fatigue among nurses: Implications for patient safety

ABSTRACT

Continuous hospital operation requires rotating schedules, night shifts, and often extended working hours for nursing staff, disrupting sleep and circadian rhythms and contributing to occupational fatigue. Fatigue reduces alertness and cognitive performance and is associated with adverse events, particularly in high-risk processes such as medication administration. The aim of the present article was to highlight factors linked to nurse fatigue, examine its impact on patient safety, and summarize evidence-based prevention and mitigation strategies. Evidence indicates that overtime, 12-hour shifts, rapid shift rotation, and inadequate staffing are related to increased sleepiness, reduced performance, and a higher probability of errors. Interruptions during medication preparation and administration further amplify risk by increasing cognitive load and reducing task continuity. Persistent fatigue is also associated with burnout, reduced job satisfaction, and intention to leave the profession. Nurse fatigue is a predictable and modifiable risk factor for patient safety and workforce sustainability. Optimized scheduling, adequate staffing, protected breaks, fatigue risk management, and standardized medication-safety practices may reduce errors and improve quality of care.

Keywords: fatigue, Nurses, Patient safety, medication, errors, shift work