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Associations Among Nurse Fatigue, Individual Nurse Factors, and Aspects of the Nursing Practice Environment

Knupp, Amy M., PhD, RN, APRN-CNS, CPPS; Patterson, Emily S., PhD; Ford, Jodi L., PhD, RN; Zurmehly, Joyce, PhD, DNP, RN, NEA-BC; Patrick, Thelma, PhD, RN

Journal of Nursing Administration: December 2018 - Volume 48 - Issue 12 - p 642–648
doi: 10.1097/NNA.0000000000000693

OBJECTIVE This study examined the relationships among nurse fatigue, individual nurse factors, and the practice environment in the inpatient setting.

BACKGROUND Nurse fatigue affects the quality of care provision on inpatient units. Scant literature exists regarding how aspects of the practice environment relate to nurse fatigue.

METHODS A cross-sectional, correlational design was used in this survey study of 175 neonatal intensive care unit nurses from multiple hospitals. Data were collected using the Checklist Individual Strength questionnaire and the Practice Environment Scale of the Nursing Work Index. Hierarchical regression analysis was performed to examine the relationships.

RESULTS Higher fatigue was significantly associated with more hours worked, fewer hours of sleep, a physical or mental contributor to fatigue, and a recent distressing patient event. Lower fatigue was significantly associated with better nurse manager ability, leadership, and support.

CONCLUSIONS Nurse fatigue may be diminished with organizational and individual strategies. Developing tactics for nurse managers to better support staff members after a recent distressing patient event is indicated.

Author Affiliations: Associate Director Continuing Nursing Education (Dr Knupp), The Ohio State University Wexner Medical Center, Columbus; Associate Professor (Dr Patterson), School of Health and Rehabilitation Sciences, The Ohio State University, Columbus; Associate Professor (Dr Ford), Associate Professor, Director of Doctor of Nursing Practice Program (Dr Zurmehly), Associate Professor (Dr Patrick), College of Nursing, The Ohio State University, Columbus.

The authors declare no conflict of interest.

This research was supported by an Agency for Healthcare Research and Quality (AHRQ) grant (P30HS024379). The views are those of the authors and not necessarily those of AHRQ. Funding for this study was received from the Sigma Theta Tau International Epsilon Chapter Small Grant Award.

Correspondence: Dr Knupp, The Ohio State University Wexner Medical Center, PO Box 182495. Columbus, OH 43218-2495 (

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