Psychological hardiness, sleepiness, and fatigue as predictors of occupational errors in nurses: implications for enhancing nurse well-being and patient safety.

Nurses are at increased risk of making professional errors due to a combination of interrelated factors. We investigated the effects of sleepiness, fatigue, psychological hardiness, and demographic factors on the frequency of medical errors among active nurses. A cross-sectional study was conducted including 346 (47.7% males) nurses from two hospitals in Tehran, Iran. All participants had at least a Bachelor of Science in Nursing. A machine-learning model showed good performance in predicting the frequency of occupational errors with an average (SD) root mean squared error of 2.82 (0.55), mean absolute error of 1.57 (0.38), and R-squared of 0.53 (0.19). Nurses with higher hardiness showed fewer errors, while those with greater sleepiness and fatigue reported more. Experience and age were negatively correlated with error frequency. This study provided insights into nurse well-being and patient safety and highlighted the complex relationships between psychological and physiological factors in occupational errors.