Date of Completion


Document Type

Campus Access Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Faculty Advisor

Eileen Stuart-Shor, PhD

Site Advisor

Mary Fischer, PhD

Second Reader

Megan Arbour, PhD


BACKGROUND: There is increasing evidence of the adverse effects of acute and chronic sleep deprivation. Workers on extended duty or night shift have higher rates of motor vehicle accidents, work injuries, and errors. In healthcare, sleep loss is associated with medical and diagnostic errors, needlestick and sharps related injuries, and attentional failures. Sleep deprivation is also associated with increased rates of stroke, obesity, diabetes, cardiovascular disease, osteoporosis, preterm labor, and mortality.

Many industries have shift length restrictions to decrease the risk of sleep deprivation, but there are no duty hour limitations for midwives in the United States. The nature of maternity care puts midwives at significant risk for both acute and chronic sleep loss. In 2015, the American College of Nurse-Midwives (ACNM) convened a Sleep and Safety Task Force to investigate sleep loss and fatigue within the profession and to craft a position statement for on Fatigue and Safety. A priority identified by this task force was the education of midwives on the risks of sleep deprivation in the profession. The purpose of this project was to implement an evidence-based educational initiative for midwives, focused on the risks of sleep deprivation.

METHODS: Educational sessions conducted both live and on-line were conducted to increase awareness in the midwifery community of the risks of sleep loss in midwifery practice and of the new position statement from the ACNM. Sessions awarded continuing education credit from the ACNM.

INTERVENTION: Continuing education sessions on Sleep and Safety were offered, one live at the ACNM annual meeting and one as a webinar, offered live and recorded. Sessions included information on safety and health risks of acute and chronic sleep deprivation, recent data on the prevalence of sleepiness and safety issues within the profession, and a discussion of management models to decrease the risks of sleep deprivation. Self-reported knowledge, intent to change behavior/practice, and perceived barriers to change in practice were collected via post session questionnaires.

RESULTS: Attendance at the two educational sessions varied, with larger attendance at the ACNM annual meeting. All attendees reported an increase in knowledge around sleep deficit and strategies to reduce the dangers of fatigue, drowsy driving, and clinical errors. Webinar attendees reported intent to change sleep/call habits and employ strategies to prevent drowsy driving. The predominant barrier to practice change identified by attendees was staffing.

CONCLUSIONS: Sleep loss poses both safety and health risks for midwives. Educational sessions were effective, with attendees reporting increased knowledge and intent to change habits. The predominant barrier identified was lack of adequate staffing to change on call coverage. Future efforts to decrease the prevalence and risk of sleep loss in midwifery practice are needed, but attendees identified the new position statement from the ACNM as a supportive start.


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