Interactive Effects of Sleep Difficulty and Time Pressure on Patient Safety in Nurses in Public Hospitals

Purpose There is no report about the interaction effect of insomnia and time pressure on patient safety. This investigation aimed to examine the interactive effect of insomnia and perceived time pressure on safety events to patients in nurses of general public hospitals. Methods In this cross-sectional study, 111 nurses with different educational levels and experiences were included from four general public hospitals in Iraqi Kurdistan in 2019. Patient safety was assessed by the frequency of incidents to patients for the past year. The nurse-perceived time pressure was rated from 1 (never) to 7 (always). The severity of sleep difficulty was measured by the Athens Insomnia Scale. The interactive effect of insomnia and time pressure on safety events was examined in a multivariate analysis model. Results The mean age of nurses was 29.87 ± 5.19 years and worked in different shifts. The mean sleep severity was 7.73 ± 3.0 of 24.0, including 76.6% insomniac nurses. The nurses injured patients during caregiving (79.3%), patients fell (71.2%), nosocomial infections occurred (82.9%), documented/recorded medical information incompletely or incorrectly (75.7%). Nurses delayed the patients' care (81.1%) and administered medication by an error (71.2%). The nurses with higher time pressure and insomnia severity were more likely to exert injuries to patients due to care ( P = 0.001), their patients fell ( P = 0.003), administered medication with errors ( P = 0.006). Conclusions This study showed that the nurse-perceived time pressure is escalated with the severity of insomnia in nurses. In addition, the interaction of insomnia and perceived time pressure in nurses were associated with more adverse events to patients.