Volume : 12, Issue : 12, December- 2025
Title:
THE EFFICACY OF FATIGUE RISK MANAGEMENT SYSTEMS (FRMS) BEYOND SHIFT LENGTH: A SYSTEMATIC REVIEW OF NAPPING, EDUCATION, AND SCHEDULING INTERVENTIONS IN EMS
Authors :
Yaser Muhammad Almutairi, Abdulsalam Murayshid Almutairi, Nasser Abdullah Nasser Zoaid, Abdullah Mazen Alharbi, Tariq Ibrahim Rasheed Aljurbua, Faris Sanad Almutairi, Bandar Nasser Mohammad Al-Badl, Abdulrahman Mohammed Sabil Alharbi, Essa Munif Alharbi, Obaid Jahaz Almutairi
Abstract :
Fatigue poses a significant occupational health risk in Emergency Medical Services (EMS) due to round-the-clock operations, high cognitive demands, and circadian disruptions. While shift length limits are common, a comprehensive Fatigue Risk Management System (FRMS) provides a broader, multi-faceted approach. This systematic review aimed to synthesize evidence on the effectiveness of three core FRMS interventions—napping, fatigue education, and scheduling modifications—within EMS, focusing on fatigue, safety, and performance outcomes. A systematic search of six databases (PubMed, EMBASE, CINAHL, PsycINFO, Scopus, TRID) and grey literature was conducted through March 2024, according to a pre-registered protocol (PROSPERO: CRD42024512345). Studies involving EMS personnel that evaluated napping, education, or scheduling interventions were included. Two reviewers independently screened, extracted data, and assessed quality. A narrative synthesis was performed due to methodological diversity. Thirty-two studies were included. Evidence strongly supports intra-shift napping (30-90 minutes) as it significantly enhances alertness and vigilance. Structured education effectively boosts fatigue knowledge. Forward-rotating schedules and mandated minimum rest periods (≥12 hours) are also supported. However, barriers exist, including logistical challenges with napping, inadequate behavior change from education alone, and cultural stigma. This review advocates for a bundled FRMS approach in EMS that integrates education, science-based scheduling, and protected napping. Achieving success necessitates committed leadership, explicit policies, and a cultural shift to prioritize fatigue management. Future research should focus on longitudinal trials, cost-benefit analyses, and implementation science.
Keywords: Fatigue Risk Management System (FRMS); Emergency Medical Services (EMS); Shift Work; Occupational Fatigue; Systematic Review
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Cite This Article:
Please cite this article in press Yaser Muhammad Almutairi et al., Review On Rp-Hplc Methodologies For Simultaneous Estimation Of Antibacterial Drug Linezolid And Its Impurities, Indo Am. J. P. Sci, 2025; 12(12).
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