Time lost: Factors influencing advanced practice provider's prioritization of sleep.

Background: Prescribing patient care providers regularly experience insufficient sleep, putting them at increased risk of committing occupational injuries, accidents, and errors and developing chronic health conditions.
Objective: Identify antecedents to short sleep (≤6-hours sleep in 24-hour period) in the understudied population of hospital-based Advanced Practice Providers (APPs).
Methods: Using an ethnographic research design, data included APP and key stakeholder interviews, hospital observations, and relevant documents. Interview data were analyzed using modified constant comparative method.
Results: Nine APPs were interviewed, revealing four themes: Social/Family Obligations and Value of Connectivity, Community Value of Sleep, Organizational Value of Sleep, and Individual Biology and How the Body Values Sleep. APP decisions to prioritize sleep are based on an interplay of societal, professional, organizational, and personal values. Triangulated data verified results, except regarding how APP sleep deficit can lead to mood disturbances and the lack sleep consideration in patient care error reporting.
Conclusions: Findings demonstrate the importance of consistency in messaging, action, and policy when promoting occupational sleep health among healthcare workers. Implications include instituting worker sleep education, leadership modeling healthy sleep habits, and inclusion of sleep in root cause analyses. Additional consideration includes evaluating the influence of nursing culture on nurse practitioners' sleep habits.