Fatigue ManagementIssues and Solutions

SESSION OVERVIEW

• Human v1.0 - Our Need for Sleep

• Consequences of Fatigue

• Fatigue Management in Practice

HUMAN v1.0

0000 0600 1200 18000600 1200 1800

Our need for Sleep

Timing is everything

Evolution of the 24h society

< 50% get adequate

sleep

Lack of sleep is a problem for all of us ….

45% wake feeling

unrefreshed

http://www.nih.gov

Not just about how much …

http://www.nih.gov

CONSEQUENCES OF FATIGUE

Fatigue can be defined as...decreased capability to perform mental or physical work, produced as a function of inadequate sleep,

circadian disruption, or time on task.

(Brown, 1994)

Fatigue

Fatigue can be defined as...decreased capability to perform mental or physical work, produced as a function of inadequate sleep,

circadian disruption, or time on task.

(Brown, 1994)

Fatigue

Fatigue can be defined as...decreased capability to perform mental or physical work, produced as a function of inadequate sleep,

circadian disruption, or time on task.

(Brown, 1994)

Fatigue

Fatigue can be defined as...decreased capability to perform mental or physical work, produced as a function of inadequate sleep,

circadian disruption, or time on task.

(Brown, 1994)

Fatigue

[Belenky et al. 2003]

Mea

n R

eact

ion

Tim

e (1

/RT*

1000

)

Mean Reaction Time Faster

Slower

Shift type Nights (consecutive) Hours (1-12)

(Folkard and Tucker, 2001)

INJURY RISK~ 30%

increase~ 30%

increase~ 100% increase

Error Rates

Gastrointestinal Disease

Cardiovascular Disease

Type Two Diabetes

Reproductive Disorders

Certain Cancers

the list goes on…

FATIGUE MANAGEMENT

A good roster is no longer sufficient to manage fatigue-related risk…

Hours of Service Rules

It is not just about rostering

Activity Level Sleep DutyOnly 4.3h sleep in 24h prior to the shift

Rostering - Day shift following a weekend away from work

Organisation = Safe System of Work- Effective Rosters and Working Time Arrangements- Provision of Education- Provision of Tools for Risk Assessment- Provision of Risk Mitigation Strategies

Supervisor = Everyday Management- Implementation of Organisational Systems- Support for Risk Assessment and Subsequent Decisions- Creating a Culture of Risk Assessment and Informed Decision Making

Employee = Fitness for Duty / Dynamic Risk Management- Honest Self Assessment of Risk (using tools provided)- Taking Required Action to Mitigate Risk- Fatigue “proofing” the work task

SHARED RESPONSIBILITY MODEL

Risk Management

Risk management – what’s that mean?- assessing risk- introducing controls- in the workplace its about multiple layers of controls

Fatigue Risk Management

Defences in DepthBased on the James Reason (1997) model that for an incident to occur a number of systems, or defences, have to fail.

(Dawson and McCulloch, 2005)

Grigsby-Toussaint, D. S., Shin, J. C., Reeves, D. M., Beattie, A., Auguste, E., & Jean-Louis, G. (2017). Sleep apps and behavioral constructs: A content analysis. Preventive Medicine Reports, 6, 126-129.

Keep track of sleep & wake

- last night- the night before

Control Strategies:

Temporary measures to help keep you safe

•Napping•Take a break •Supervision and communication•Task rotation•Double checks and checklists (work in pairs)•Monitoring performance (self and others) - Keep and eye on each other•Handover protocols to reduce chance of missing things (helps sleep too)•Caffeine•Light Exposure

http://library.safework.sa.gov.au/

Thank you…

Fatigue ManagementSESSION OVERVIEWHUMAN v1.0Slide Number 4Slide Number 5Slide Number 6Slide Number 7Slide Number 8CONSEQUENCES OF FATIGUEFatigueFatigueFatigueFatigueSlide Number 14Slide Number 15INJURY RISKError RatesSlide Number 18FATIGUE MANAGEMENTSlide Number 20Slide Number 21Slide Number 22SHARED RESPONSIBILITY MODELFatigue Risk ManagementSlide Number 25Slide Number 26Control Strategies:Slide Number 28Slide Number 29Slide Number 30Thank you…