Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Recommendation 6.0 Organization Recommendations


6.1 Organizations and academic centres promote a culture that recognizes nurse fatigue as a risk to patient and nurse safety that must be addressed by comprehensive fatigue prevention and management program that includes:
a)       Educating staff and leadership on fatigue management 
b)       Developing mechanism to document fatigue and analyze its relationship to overtime, medication errors, and patient and staff outcomes. 
c)       Providing fatigue assessment through orientation and through other training opportunities. 
d)       Available support services to nurses, such as wellness initiatives the employee assistance program (EAP), to assist with the contributors to their fatigue  
 6.2   Organizations plan, implement, and evaluate staffing and workload practices that aid in preventing nursing fatigue to ensure nurse and patient safety by:
a)       Creating adequate staffing to reduce workload in order to mitigate nurse fatigue
6.3 Organizations implement a policy on safe scheduling at no more than 12 hours in 24 and no more than 50 hours per seven day work week
a)       Scheduling for nights should not involve more than three 12 hour night shifts in a row and a longer interval of “off duty” time between blocks of shifts to recover
6.4    Organizations develop and implement a policy in consultation with Nursing Unit Councils, Occupational Health/Wellness department, Scheduling Committees, Unions, and Regulatory Bodies to set limits on the amount of overtime worked by nurses 
6.5   Organization to develop a policy on supporting planned opportunities and/or scheduled breaks and in an area conducive to rest (sleep) during break time.
a)       Create an area that is safe, and secure, where nurses can generally take uninterrupted (excluding emergencies) rest periods during breaks that are supported by administrative policies. The individual nurse retains professional accountability and responsibility to respond to emergencies.