Date of Conferral

6-13-2024

Date of Award

6-13-2024

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Management

Advisor

Miriam Ross

Abstract

Nursing is an occupation with extensive duties affecting patient safety and extensive patient practices. The purpose of this integrative review was to search the existing body of knowledge related to intensive care or critical care nurses to assess work hours and other contributors to nurse fatigue and how this relates to quality patient outcomes. The review question explored the best practices to reduce nurse fatigue in intensive care or critical care related to long shifts and other factors and the relationship to patient outcomes. Methods involved thoroughly analyzing current empirical and nonempirical literature to determine themes for answering the review question. The healthy work environment theoretical framework supported these results by identifying how to manage logical support systems through progressive leadership activities. Results of the analysis showed six themes: decreased nurse turnover, healthy environment, teamwork, improved quality care, trustworthy leadership, and effective nursing leadership; there were 13 sub-themes: stress management, job demands, staff education, control/demand issues, reduced overtime, well-being, appropriate staffing, staff meetings, effective communication, motivation, support management, decision-making, and engagement. Conclusions indicated that the predominant best practices for positive social change in order to reduce nurse fatigue on critical care units are an encouraging work culture and nurse engagement in a positive organizational culture that is supported by a proactive corporate management team.

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