Exploring the Relationship Between Sleep Deprivation and Clinical Decision Errors Among Nurses

Posted: May 26, 2021

• Georgia Ford
• Dean Hawkins
• Lillian Gomez

Abstract

The nursing profession represents a critical frontline in healthcare delivery, where clinical decisions carry immediate consequences for patient safety and outcomes. Despite extensive research on medical errors, the specific cognitive mechanisms through which sleep deprivation influences nursing judgment remain inadequately understood. Traditional approaches to studying this relationship have relied on self-reported sleep data and retrospective error reporting, methods that suffer from recall bias and insufficient temporal resolution. Our research addresses these limitations through an innovative methodology that combines high-frequency sleep monitoring with real-time error detection, enabling unprecedented insight into the dynamics of fatigue-related clinical decision-making. What distinguishes this study from previous work is its focus on the cognitive architecture of nursing decisions under sleep-deprived conditions. Rather than treating errors as discrete events, we conceptualize them as manifestations of compromised cognitive processes that unfold over time and across clinical tasks. This perspective allows us to identify not just when errors occur, but how the quality of clinical reasoning deteriorates as sleep debt accumulates. The nursing context presents unique challenges, as decisions often involve complex pattern recognition, rapid prioritization, and emotional regulation—cognitive functions known to be particularly vulnerable to sleep loss.