Objective Assessment of Fitness to Perform (FTOP) After Surgical Night Shifts in the Netherlands
| Autor: | Tummers, F.H.M.P., Huizinga, C.R.H., Stockmann, H.B.A.C., Hamming, J.F., Cohen, A.F., Bogt, K.E.A. van der, Steenhoven, T.J. van der, Kam, M. de, Pampus, M.G. van, Oordt, C. .J. van, Legemate, D.A., Toorenvliet, B.R., Wever, J.J., Lijkwan, M.A., FTOP Collaborators |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Self-assessment Self-Assessment night shift medicine.medical_specialty Consultants work hour directive MEDLINE night call Objective assessment Cohort Studies 03 medical and health sciences fit to perform 0302 clinical medicine After-Hours Care Work Schedule Tolerance Task Performance and Analysis patient safety Humans Medicine Attention Prospective Studies sleep-deprived Prospective cohort study work hours alertness Netherlands Surgeons business.industry Internship and Residency Reproducibility of Results organization of care Alertness Physical Fitness General Surgery 030220 oncology & carcinogenesis Physical therapy Female fatigue 030211 gastroenterology & hepatology Surgery Observational study Clinical Competence business Cohort study |
| Zdroj: | Annals of Surgery, 270(5), 930-936. LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 1528-1140 0003-4932 |
| DOI: | 10.1097/sla.0000000000003517 |
| Popis: | Background: Surgical skills and decision making are influenced by alertness, reaction time, eye-hand coordination, and concentration. Night shift might impair these functions but it is unclear to what extent. The aim of this study was to investigate whether a night shift routinely impairs the surgeon's fitness to perform and whether this reaches a critical limit as compared to relevant frames of reference.Methods: Consultants (n = 59) and residents (n = 103) conducted fitness to perform measurements at precall, postcall, and noncall moments. This validated self-test consists of an adaptive tracker that is able to objectively measure alertness, reaction time, concentration, and eye-hand coordination, and multiple visual analog scales to subjectively score alertness. Results are compared to sociolegal (ethanol) and professional (operative skills) frames of reference that refer to a decrease under the influence of 0.06% ethanol.Results: Residents spent 1.7 call hours asleep on average as compared to 5.4 for consultants. Subjective alertness decreased in residents after night shifts (-13, P < 0.001) but not in consultants (-1.2, P = NS). The overnight difference in tracker score was -1.17 (P < 0.001) for residents and 0.46 (P = NS) for surgeons. Postcall subjective alertness only correlated to objective alertness in consultants. For residents, hours slept on-call correlated to objective alertness. For consultants, subsequent night calls significantly correlated to objective alertness, with the third subsequent call related to performance below the reference.Conclusions: Consultants remain fit to perform after night call, but subsequent calls may compromise clinical activities. This study provides insight and awareness of individual performance with clear frames of reference. |
| Databáze: | OpenAIRE |
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