No Comment Necessary
Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
Christopher P. Landrigan, M.D., M.P.H., Jeffrey M. Rothschild, M.D., M.P.H., John W. Cronin, M.D., Rainu Kaushal, M.D., M.P.H., Elisabeth Burdick, M.S., Joel T. Katz, M.D., Craig M. Lilly, M.D., Peter H. Stone, M.D., Steven W. Lockley, Ph.D., David W. Bates, M.D., Charles A. Czeisler, Ph.D., M.D., for the Harvard Work Hours, Health and Safety Group
ABSTRACT
Background Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours.
Methods Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98).
Results Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule.
Conclusions Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.
Christopher P. Landrigan, M.D., M.P.H., Jeffrey M. Rothschild, M.D., M.P.H., John W. Cronin, M.D., Rainu Kaushal, M.D., M.P.H., Elisabeth Burdick, M.S., Joel T. Katz, M.D., Craig M. Lilly, M.D., Peter H. Stone, M.D., Steven W. Lockley, Ph.D., David W. Bates, M.D., Charles A. Czeisler, Ph.D., M.D., for the Harvard Work Hours, Health and Safety Group
ABSTRACT
Background Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours.
Methods Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98).
Results Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule.
Conclusions Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours.
(Note: The Corpus Callosum has moved. Visit the new site here.)
posted by : Joseph j7uy5 at 10/27/2004 11:59:00 PM
:
Joseph j7uy5
<< Home