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If we are aware that an error is more likely we can be more proactive in detecting them. Alongside distractions, two common situations that make errors more likely are stress and fatigue. Stress is not only a source of error when we are overworked and overstimulated, but also, at the other end of the spectrum, when we are understimulated we become inattentive.

The acronym HALT has been used to describe situations when error is more likely:

H	Hungry
A	Angry
L	Late
T	Tired

Consider how many times in the last week you have been hungry, angry, late or tired and still worked in a setting where errors could have had significant implications. Unfortunately, in many work cultures these emotional and/or physical states are seen as inevitable.

I’M SAFE has been used as a checklist in the aviation industry, asking whether the individual may be affected by:

I	Illness
M	Medication
S	Stress
A	Alcohol
F	Fatigue
E	Eating

Ideally, individuals who are potentially compromised need to be supported appropriately, allowed time to recover and the team made aware. How this can be achieved in the middle of a night shift can be problematic.