Examining Shift Length and Fatigue: A National Study of Neonatal Advanced Practice Providers

Document Type

Article

Publication Date

2-1-2025

Publication Title

Advances in neonatal care

Keywords

Humans, Fatigue, Intensive Care Units, Neonatal, Female, Surveys and Questionnaires, Male, Clinical Competence, Infant, Newborn, Adult, Shift Work Schedule, Work Schedule Tolerance, Psychomotor Performance, Clinical Decision-Making

Abstract

BACKGROUND: Neonatal advanced practice providers (APPs) often work prolonged hours in high-acuity neonatal intensive care units (NICUs). It is imperative to understand how fatigue affects the APP's ability to react quickly following long shifts. There is a lack of data on the effects of shift length and fatigue on neonatal APP job performance and clinical decision-making.

PURPOSE: The purpose of this study was to describe the variation in shift length, knowledge-based competency, personal well-being, and behavioral alertness for neonatal APPs.

METHODS: This study evaluated neonatal APPs before and after a clinical shift. Provider well-being was assessed during the pre-survey. Pretest-posttest surveys evaluated neonatal APP's psychomotor vigilance skills and knowledge. Participants completed an online, anonymous questionnaire to answer a series of knowledge-based questions before and after their shift, along with a psychomotor vigilance test (PVT). A paired t test analysis evaluated the pre- and post-shift PVT values and knowledge-based test scores.

RESULTS: Overall, 61 pre-surveys and 42 post-surveys were completed; 36 were matched by participants pre- to post-survey. The mean between pre- and post-knowledge-based questions was statistically significant, with higher posttest scores. There was no statistical difference noted in the paired t test analysis of the PVT values.

IMPLICATIONS FOR PRACTICE AND RESEARCH: The small sample size may limit the generalizability of findings, but these results may indicate that shift length does not affect psychomotor vigilance or knowledge-based competency. It is vital that future work assess the associations between APP shift length, fatigue, and critical decision-making.

Medical Subject Headings

Humans; Fatigue; Intensive Care Units, Neonatal; Female; Surveys and Questionnaires; Male; Clinical Competence; Infant, Newborn; Adult; Shift Work Schedule; Work Schedule Tolerance; Psychomotor Performance; Clinical Decision-Making

PubMed ID

39724563

ePublication

ePub ahead of print

Volume

25

Issue

1

First Page

70

Last Page

76

Find It @ Sladen

Share

COinS