Measuring and modeling the effects of fatigue on performance: Specific application to the nursing profession

dc.contributor.authorBarker, Linsey Marinnen
dc.contributor.committeechairNussbaum, Maury A.en
dc.contributor.committeememberSmith-Jackson, Tonya L.en
dc.contributor.committeememberKleiner, Brian M.en
dc.contributor.committeememberBabski-Reeves, Kari L.en
dc.contributor.departmentIndustrial and Systems Engineeringen
dc.date.accessioned2014-03-14T20:14:13Zen
dc.date.adate2009-07-29en
dc.date.available2014-03-14T20:14:13Zen
dc.date.issued2009-07-21en
dc.date.rdate2009-07-29en
dc.date.sdate2009-07-23en
dc.description.abstractHigh rates of medical errors are well documented within the healthcare industry. Nurses, in particular, play a critical role in the quality and safety of healthcare services. Fatigue is a factor that has been linked to stress, safety, and performance decrements in numerous work environments. Within healthcare, however, a comprehensive definition of fatigue encompassing multiple dimensions has not been considered, but is warranted since nurses perform tasks consisting of diverse physical and mental activities. As such, "total fatigue" was examined, as were interactions between its underlying dimensions and the effects of these dimensions on performance, in the context of actual and simulated nursing work. In a survey study (Chapter 2), registered nurses reported relatively high levels of mental, physical, and total fatigue, and higher levels of fatigue were associated with perceived decreases in performance. Work environment variables, such as work schedule or shift length, were also related to differences in reported fatigue levels. An experimental study investigated causal effects of mental and physical fatigue on mental and physical performance (Chapter 3). Mental fatigue affected a measure of mental performance, and physical fatigue had a negative effect on measures of physical and mental performance. A multidimensional view of fatigue that considers direct and crossover effects between mental and physical dimensions of fatigue and performance is relevant when quantifying effects of fatigue on performance. A model of the relationships between fatigue dimensions and performance in nursing was developed using structural equation modeling techniques (Chapter 4). The model supported the existence of a total fatigue construct that is directly affected by mental and physical fatigue levels. The final model also provides quantitative path coefficients defining the strength of relationships between mental and physical dimensions of fatigue, total fatigue, and mental and physical performance. The current research provides an increased understanding of fatigue levels in registered nurses across work environments, as well as the underlying causal mechanisms between dimensions of fatigue and performance decrements. The findings and the final model can aid in designing interventions to reduce or eliminate the contributions of fatigue to the occurrence of medical errors.en
dc.description.degreePh. D.en
dc.identifier.otheretd-07232009-101727en
dc.identifier.sourceurlhttp://scholar.lib.vt.edu/theses/available/etd-07232009-101727/en
dc.identifier.urihttp://hdl.handle.net/10919/28371en
dc.publisherVirginia Techen
dc.relation.haspartBarkerDissertationETDSubmission.pdfen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectFatigueen
dc.subjectmedical errorsen
dc.subjectnursingen
dc.subjectstructural equation modelingen
dc.subjectPerformanceen
dc.titleMeasuring and modeling the effects of fatigue on performance: Specific application to the nursing professionen
dc.typeDissertationen
thesis.degree.disciplineIndustrial and Systems Engineeringen
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.leveldoctoralen
thesis.degree.namePh. D.en

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