Effect on Patient Safety of a Resident Physician Schedule without 24-Hour Shifts
| Autor: | Amy L. Sanderson, Michael V. Vitiello, Jason P. Sullivan, Pearl L. Yu, Phyllis C. Zee, Christopher P. Landrigan, Charles A. Czeisler, Conor S O'Brien, Shadab A. Rahman, Sue E. Poynter, Steven W. Lockley, Ann C. Halbower, Katie L. Stone, Laura K. Barger, Melissa A. St. Hilaire, John K. McGuire, Salim Qadri, Jeffrey L. Segar, Horacio O. de la Iglesia, Eric Vittinghoff, Kenneth P. Wright |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Time Factors Control (management) Clinical Trials and Supportive Activities Personnel Staffing and Scheduling Workload 030204 cardiovascular system & hematology Intensive Care Units Pediatric Medical and Health Sciences Article law.invention 03 medical and health sciences Patient safety 0302 clinical medicine Randomized controlled trial law Clinical Research Intervention (counseling) Work Schedule Tolerance General & Internal Medicine medicine Humans 030212 general & internal medicine Pediatric Cross-Over Studies Medical Errors business.industry Prevention Obstetrics and Gynecology Internship and Residency General Medicine Intensive care unit Crossover study Confidence interval Intensive Care Units Relative risk Emergency medicine Patient Safety business Sleep ROSTERS Study Group Psychomotor Performance |
| Zdroj: | N Engl J Med The New England journal of medicine, vol 382, iss 26 |
| Popis: | BACKGROUND: The effects on patient safety of eliminating extended-duration work shifts for resident physicians remain controversial. METHODS: We conducted a multicenter, cluster-randomized, crossover trial comparing two schedules for pediatric resident physicians during their intensive care unit (ICU) rotations: extended-duration work schedules that included shifts of 24 hours or more (control schedules) and schedules that eliminated extended shifts and cycled resident physicians through day and night shifts of 16 hours or less (intervention schedules). The primary outcome was serious medical errors made by resident physicians, assessed by intensive surveillance, including direct observation and chart review. RESULTS: The characteristics of ICU patients during the two work schedules were similar, but resident physician workload, described as the mean (±SD) number of ICU patients per resident physician, was higher during the intervention schedules than during the control schedules (8.8±2.8 vs. 6.7±2.2). Resident physicians made more serious errors during the intervention schedules than during the control schedules (97.1 vs. 79.0 per 1000 patient-days; relative risk, 1.53; 95% confidence interval [CI], 1.37 to 1.72; P |
| Databáze: | OpenAIRE |
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