Sleep deprivation and medication administration errors in registered nurses-A scoping review.

AIM: To explore whether sleep deprivation contributes to medication errors in registered nurses (RNs). BACKGROUND: Sleep deprivation is a potential issue for RNs, particularly those who work shifts. Sleep deprivation has been found to have a negative impact on numerous cognitive processes. Nurses administer several medications to patients a day, potentially while sleep deprived-anecdotal reports suggest that this could result in an increased risk of error occurring. DESIGN: A scoping review was conducted using the Prisma-ScR extension framework to explore what is known about the effect of RNs' sleep deprivation on medication administration errors. METHODS: A search of databases generated 171 results. When inclusion and exclusion criteria were applied, 18 empirical studies were analysed. Studies included retrospective analysis of errors, surveys of perceptions of causes and observational studies. RESULTS: Data indicated that RNs consider fatigue, which may be caused by sleep deprivation, to be a contributing factor to medication errors. The search only identified three observer studies, which provided conflicting results as to whether lack of sleep contributes to the error rate. Of the numerous tools used to measure sleep, the Pittsburgh Sleep Quality Index was the most frequently used. CONCLUSION: Although RNs anecdotally consider a lack of sleep potentially contributes to medication errors, there is insufficient research to provide robust evidence to confirm this assumption. NO PATIENT OR PUBLIC CONTRIBUTIONS: Patient or public contributions were not required for this scoping review. RELEVANCE TO CLINICAL PRACTICE: Sleep deprivation is a potential issue for nurses, especially those who work shifts. Poor sleep impacts cognitive processes that potentially could increase errors. Nurses should be aware of the impact sleep may have on patient safety.

Factors affecting maternal perception of fetal movement.

Maternal perception of fetal movement is an important screening method for fetal well-being, as decreased fetal movement is associated with a range of pregnancy pathologies and poor pregnancy outcomes. An understanding of factors that may affect perception could help clinicians to determine the importance of maternal reports of decreased fetal movement. This review considers factors that may affect maternal perception of fetal movement and the sensitivity of maternal perception of fetal movements in comparison with ultrasound and other objective methods of movement detection. There is conflicting evidence on whether parity, gestational age, overweight and obesity, and placental location affect perception. This may be related to the small sample sizes of available studies and lack of consistent definitions of factors that may affect the ability of mothers to perceive movement. There is some evidence that psychological factors and duration of fetal movement may affect perception, and that strong movements and those including trunk movement are more likely to be perceived. The proportion of fetal breathing movements that mothers perceive has not been investigated. Research is also lacking as to whether there needs to be contact of fetal part(s) with maternal structures for movement to be perceived, and whether fetal position, amniotic fluid volume, maternal position, sedatives, or other drugs affect movement perception.