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UW-Madison Project Uses mHealth to Study Nurse Stress, Fatigue

A University of Wisconsin-Madison researcher is using Fitbits to track nurse activity and sleep in an mHealth project aimed at reducing stress and fatigue in an often overworked provider population.

Source: ThinkStock

By Eric Wicklund

- A new mHealth project in Wisconsin aims to use Fitbits to monitor – and ultimately improve – nurses’ health.

University of Wisconsin-Madison School of Nursing Professor Linsey Steege will use the popular digital health wearable to track the activities of selected nurses throughout the day, gathering data on their steps, heart rate and sleep. Her goal is to identify factors that cause fatigue and stress on an often-overlooked (and overworked) but vital care provider population.

“I became interested in focusing on how to improve how we support nurses so that they in turn can be safe and provide the highest quality patient care,” she said in a news story produced by the university. “(But) when I looked around, there was a lot of research on physical fatigue (and) sleep deprivation for medical residents, but much less on how nursing work is contributing to fatigue and how fatigue is contributing to stress, burnout, and worst of all, medical error.”

“For me it’s a real exciting opportunity to use data to positively impact how we take care of ourselves as nurses and to understand what contributes to nurse fatigue in the inpatient environment,” adds Rebecca Rankin, the director of informatics for UW Health, which is participating in Steege’s project.

mHealth wearables have long been put to the test to help healthcare providers gain insight into the daily lives of their patients outside the office, but only occasionally – and recently - have they been used to support care for the caregivers. On such example lies next door, where University of Michigan researchers are using Fitbits in a long-term project to analyze stress levels in medical school interns.

“There’s a lot of potential for wearables and mHealth in helping us understand how and why stress happens,” says Srijan Sen, MD, PhD, a member of the UM Medical School Department of Psychiatry and the university’s Molecular and Behavioral Neuroscience Institute. “Now we can go everywhere that (the intern) goes.”

That’s only part of what Steege envisions in her project. She also wants to collect data on the nurse’s work environment, including noise levels, pages and calls, time spent navigating the hospital’s electronic health record platform, nurse movement patterns, shift staffing reports and even patient acuity data.

“That is what human factors engineering is - designing or modifying work environments to optimize performance while keeping people safe,” she said. “The hospital is a work environment. We tend to focus on patient safety, but we need to consider nurse safety and wellbeing as well. If health systems do not account for the burden of fatigue on their nurses, medical errors and turnover will both increase, along with cost.”

With mHealth wearables, researchers are adding a new dimension to what they’ve long tried to do with real-time location system (RTLS) technology. In the past, hospitals and health systems have used that data to chart traffic patterns and provider and patient movements in order to improve workflows and create better floor plans. Now they’re adding individual health data, looking for specific triggers that cause provider fatigue and stress.

“We cannot push the problem onto nurses by solely emphasizing self-care as a solution to fatigue,” Steege said. “It has taken us a while to get here, but health systems are realizing that work environments and policies that do not promote or that actually undermine health in providers are problems for the health system to resolve.”

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