Date of Award


Degree Type


Degree Name

Doctor of Education (EdD)


Educational Leadership

First Advisor

Rosalie Tuttle

Second Advisor

Linda L. Davison

Third Advisor

Jeffrey S. Williamson

Scholarship Domain(s)

Scholarship of Discovery


The link between health care worker fatigue and adverse events is inseparable. Errors made by registered nurses correlated with work duration, overtime and the number of adverse events (Page 2004). To promote patient safety, nurses must remain vigilant. This study determined if work hour guidelines and education regarding safety risks affected nurse work hours, the use of fatigue countermeasures, and patient outcomes. The researcher explored survey data (n=597), actual work hours, patient safety events, and quality outcomes. Data collected demonstrated nurses work hours exceeded recommendations for a safe environment. The introduction of voluntary work guidelines and education did not result in a statistically significant change in primary work hours, F (2, 556) = 2.005, p > .05, secondary work hours, F (2, 119) = 0.372, p > .05, typical work hours in a day, 2 (4) = 1.086, or in payroll reports of greater than 100 hours worked in two weeks, 2 (2) = .295, p > .05. There was statistical significance noted in the reduction of greater than three 12-hour shifts in a row, 2 (3) = 7.810, p < .05. The survey also demonstrated that nurses did not routinely use countermeasures to combat fatigue; however, there was a statistical difference in total countermeasure use following work hour guidelines and fatigue education, F (2, 592) = 7.758, p < .01. No statistical difference occurred in adverse safety events or quality outcomes following the implementation of work hour guidelines and education; however, the numbers were small.


Ed.D. dissertation completed in 2013 for Olivet Nazarene University.