Skip to main content
Erschienen in: Lung 4/2007

01.08.2007 | State of the Art Review

The Impact of Housestaff Fatigue on Occupational and Patient Safety

verfasst von: Scot A. Mountain, Bradley S. Quon, Peter Dodek, Robert Sharpe, Najib T. Ayas

Erschienen in: Lung | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Extended-duration work shifts (i.e., greater than 24 hours) for housestaff are a long-standing tradition. However, the resultant sleep deprivation and fatigue caused by these extreme work schedules pose potential threats to both physician and patient safety. We believe it is critical to understand the potential adverse consequences of housestaff fatigue to optimize shift schedules and reduce risks to both staff and patients.
Literatur
1.
Zurück zum Zitat Stern AM, Markel H (2004) A historical perspective on the changing contours of medical residency programs. J Pediatr 144:1–2PubMedCrossRef Stern AM, Markel H (2004) A historical perspective on the changing contours of medical residency programs. J Pediatr 144:1–2PubMedCrossRef
2.
Zurück zum Zitat Wallack MK, Chao L (2001) Resident work hours. The evolution of a revolution. Arch Surg 136:1426–1431PubMedCrossRef Wallack MK, Chao L (2001) Resident work hours. The evolution of a revolution. Arch Surg 136:1426–1431PubMedCrossRef
4.
Zurück zum Zitat Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA: Harvard Work Hours, Health, and Safety Group (2005) Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 352(2):125–134PubMedCrossRef Barger LK, Cade BE, Ayas NT, Cronin JW, Rosner B, Speizer FE, Czeisler CA: Harvard Work Hours, Health, and Safety Group (2005) Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med 352(2):125–134PubMedCrossRef
6.
Zurück zum Zitat Mitler MM, Miller JC, Lipsitz JJ, Walsh JK, Wylie CD (1997) The sleep of long-haul truck drivers. N Engl J Med 337:755–761PubMedCrossRef Mitler MM, Miller JC, Lipsitz JJ, Walsh JK, Wylie CD (1997) The sleep of long-haul truck drivers. N Engl J Med 337:755–761PubMedCrossRef
7.
Zurück zum Zitat Gaba DM, Howard SK (2002) Fatigue among clinicians and the safety of patients. N Engl J Med 347(16):1249–1255PubMedCrossRef Gaba DM, Howard SK (2002) Fatigue among clinicians and the safety of patients. N Engl J Med 347(16):1249–1255PubMedCrossRef
8.
9.
Zurück zum Zitat Arnedt JT, Owens J, Crouch M, Stahl J, Carskadon MA (2005) Neurobehavioral performance of residents after heavy night call vs after alcohol ingestion. JAMA 294(9):1025–1033PubMedCrossRef Arnedt JT, Owens J, Crouch M, Stahl J, Carskadon MA (2005) Neurobehavioral performance of residents after heavy night call vs after alcohol ingestion. JAMA 294(9):1025–1033PubMedCrossRef
10.
Zurück zum Zitat Van Dongen HP, Baynard MD, Maislin G, Dinges DF (2004) Systematic interindividual differences in neurobehavioral impairment from sleep loss: evidence of trait-like differential vulnerability. Sleep 27(3):423–433PubMed Van Dongen HP, Baynard MD, Maislin G, Dinges DF (2004) Systematic interindividual differences in neurobehavioral impairment from sleep loss: evidence of trait-like differential vulnerability. Sleep 27(3):423–433PubMed
11.
Zurück zum Zitat Bartel P, Offermeier W, Smith F, Becker P (2004) Attention and working memory in resident anaesthetists after night duty: group and individual effects. Occup Environ Med 61(2):167–170PubMedCrossRef Bartel P, Offermeier W, Smith F, Becker P (2004) Attention and working memory in resident anaesthetists after night duty: group and individual effects. Occup Environ Med 61(2):167–170PubMedCrossRef
12.
Zurück zum Zitat Howard SK, Gaba DM, Rosekind MR, Zarcone VP (2002) The risks and implications of excessive daytime sleepiness in resident physicians. Acad Med 77(10):1019–1025PubMedCrossRef Howard SK, Gaba DM, Rosekind MR, Zarcone VP (2002) The risks and implications of excessive daytime sleepiness in resident physicians. Acad Med 77(10):1019–1025PubMedCrossRef
13.
Zurück zum Zitat Van Dongen HP, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26:117–126PubMed Van Dongen HP, Maislin G, Mullington JM, Dinges DF (2003) The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 26:117–126PubMed
14.
Zurück zum Zitat Cajochen C, Khalsa SB, Wyatt JK, Czeisler CA, Dijk DJ (1999) EEG and ocular correlates of circadian melatonin phase and human performance decrements during sleep loss. Am J Physiol 277:R640–R649PubMed Cajochen C, Khalsa SB, Wyatt JK, Czeisler CA, Dijk DJ (1999) EEG and ocular correlates of circadian melatonin phase and human performance decrements during sleep loss. Am J Physiol 277:R640–R649PubMed
15.
Zurück zum Zitat Bjerner B, Holm A, Swensson A (1955) Diurnal variation in mental performance: a study of three shift workers. Br J Industr Med 12:103–110 Bjerner B, Holm A, Swensson A (1955) Diurnal variation in mental performance: a study of three shift workers. Br J Industr Med 12:103–110
16.
Zurück zum Zitat Downey R, Bonnet MH (1987) Performance during frequent sleep disruption. Sleep 10(4):354–363PubMed Downey R, Bonnet MH (1987) Performance during frequent sleep disruption. Sleep 10(4):354–363PubMed
17.
Zurück zum Zitat Jewett ME, Wyatt JK, Ritz-De Cecco A, Khalsa SB, Dijk DJ, Czeisler CA (1999) Time course of sleep inertia dissipation in human performance and alertness. J Sleep Res 8(1):1–8PubMedCrossRef Jewett ME, Wyatt JK, Ritz-De Cecco A, Khalsa SB, Dijk DJ, Czeisler CA (1999) Time course of sleep inertia dissipation in human performance and alertness. J Sleep Res 8(1):1–8PubMedCrossRef
18.
Zurück zum Zitat Wertz AT, Ronda JM, Czeisler CA, Wright KP Jr (2006) Effects of sleep inertia on cognition. JAMA 295(2):163–164PubMedCrossRef Wertz AT, Ronda JM, Czeisler CA, Wright KP Jr (2006) Effects of sleep inertia on cognition. JAMA 295(2):163–164PubMedCrossRef
19.
Zurück zum Zitat Dinges DF, Orne MT, Orne EC (1985) Assessing performance upon abrupt awakening from naps during quasi-continuous operations. Behav Res Methods Instrum Comput 17:37–45 Dinges DF, Orne MT, Orne EC (1985) Assessing performance upon abrupt awakening from naps during quasi-continuous operations. Behav Res Methods Instrum Comput 17:37–45
20.
Zurück zum Zitat Heffner JE, Ellis R, Zeno B (2005) Safety in training and learning in the intensive care unit. Crit Care Clin 21:129–148PubMedCrossRef Heffner JE, Ellis R, Zeno B (2005) Safety in training and learning in the intensive care unit. Crit Care Clin 21:129–148PubMedCrossRef
21.
Zurück zum Zitat Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. N Engl J Med 340(11):847–851PubMedCrossRef Teran-Santos J, Jimenez-Gomez A, Cordero-Guevara J (1999) The association between sleep apnea and the risk of traffic accidents. N Engl J Med 340(11):847–851PubMedCrossRef
22.
Zurück zum Zitat Kowalenko T, Kowalenko J, Gryzbowski M, Rabinovich A (2000) Emergency medicine resident related auto accidents – is sleep deprivation a risk factor? Acad Emerg Med 7(5):451 Kowalenko T, Kowalenko J, Gryzbowski M, Rabinovich A (2000) Emergency medicine resident related auto accidents – is sleep deprivation a risk factor? Acad Emerg Med 7(5):451
23.
Zurück zum Zitat Ayas NT, Barger LK, Cade BE, Hashimoto DM, Rosner B, Cronin JW, Speizer FE, Czeisler CA (2006) Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA 295(9):1055–1062CrossRef Ayas NT, Barger LK, Cade BE, Hashimoto DM, Rosner B, Cronin JW, Speizer FE, Czeisler CA (2006) Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA 295(9):1055–1062CrossRef
24.
Zurück zum Zitat Shanafelt TD, Bradley KA, Wipf JE, Back AL (2002) Burnout and -self-reported patient care in an internal medicine residency program. Ann Intern Med 136:358–367PubMed Shanafelt TD, Bradley KA, Wipf JE, Back AL (2002) Burnout and -self-reported patient care in an internal medicine residency program. Ann Intern Med 136:358–367PubMed
25.
Zurück zum Zitat Fletcher KE, Underwood W 3rd, Davis SQ, Mangrulkar RS, McMahon LF Jr, Saint S (2005) Effects of work hour reduction on residents’ lives. A systematic review. JAMA 294:1088–1100 Fletcher KE, Underwood W 3rd, Davis SQ, Mangrulkar RS, McMahon LF Jr, Saint S (2005) Effects of work hour reduction on residents’ lives. A systematic review. JAMA 294:1088–1100
26.
Zurück zum Zitat Parshuram CS, Dhanani S, Kirsh JA, Cox PN (2004) Fellowship training, workload, fatigue and physical stress: a prospective observational study. Can Med Assoc J 170(6):965–970CrossRef Parshuram CS, Dhanani S, Kirsh JA, Cox PN (2004) Fellowship training, workload, fatigue and physical stress: a prospective observational study. Can Med Assoc J 170(6):965–970CrossRef
27.
Zurück zum Zitat Zheng H, Patel M, Hryniewicz K (2006) Association of extended work shifts, vascular function, and inflammatory markers in internal medicine residents: a randomized crossover trial. JAMA 296(9):1049–1050PubMedCrossRef Zheng H, Patel M, Hryniewicz K (2006) Association of extended work shifts, vascular function, and inflammatory markers in internal medicine residents: a randomized crossover trial. JAMA 296(9):1049–1050PubMedCrossRef
28.
Zurück zum Zitat Taffinder NJ, McManus IC, Gul Y, Russell RC, Darzi A (1998) Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. Lancet 352:1191PubMedCrossRef Taffinder NJ, McManus IC, Gul Y, Russell RC, Darzi A (1998) Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. Lancet 352:1191PubMedCrossRef
29.
Zurück zum Zitat Barger LK, Ayas NT, Cade BE, Cronin JW, Rosner B, Speizer FE, Czeisler CA (2006) Impact of extended-duration shifts on medical errors, adverse events, and attentional failures. PLoS Med 3(12):1–9CrossRef Barger LK, Ayas NT, Cade BE, Cronin JW, Rosner B, Speizer FE, Czeisler CA (2006) Impact of extended-duration shifts on medical errors, adverse events, and attentional failures. PLoS Med 3(12):1–9CrossRef
30.
Zurück zum Zitat Ellman PI, Law MG, Tache-Leon C, Reese TB, Maxey TS, Peeler BB, Kern JA, Tribble CG, Kron IL (2004) Sleep deprivation does not affect operative results in cardiac surgery. Ann Thorac Surg 78:906–911PubMedCrossRef Ellman PI, Law MG, Tache-Leon C, Reese TB, Maxey TS, Peeler BB, Kern JA, Tribble CG, Kron IL (2004) Sleep deprivation does not affect operative results in cardiac surgery. Ann Thorac Surg 78:906–911PubMedCrossRef
31.
Zurück zum Zitat Lockley SW, Cronin JW, Evans EE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA, Harvard Work Hours, Health, Safety Group (2004) Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med 351(18):1829–1837PubMedCrossRef Lockley SW, Cronin JW, Evans EE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA, Harvard Work Hours, Health, Safety Group (2004) Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med 351(18):1829–1837PubMedCrossRef
32.
Zurück zum Zitat Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA (2004) Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med 351(18):1838–1848PubMedCrossRef Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA (2004) Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med 351(18):1838–1848PubMedCrossRef
33.
Zurück zum Zitat Afessa B, Kennedy CC, Klarich KW, Aksamit TR, Kolars JC, Hubmayr RD (2005) Introduction of a 14-hour work shift model for housestaff in the medical ICU. Chest 128(6):3910–3915PubMedCrossRef Afessa B, Kennedy CC, Klarich KW, Aksamit TR, Kolars JC, Hubmayr RD (2005) Introduction of a 14-hour work shift model for housestaff in the medical ICU. Chest 128(6):3910–3915PubMedCrossRef
34.
Zurück zum Zitat Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH (1994) Does housestaff discontinuity of care increase the risk for preventable adverse effects? Ann Intern Med 121:866–872PubMed Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH (1994) Does housestaff discontinuity of care increase the risk for preventable adverse effects? Ann Intern Med 121:866–872PubMed
35.
Zurück zum Zitat Laine C, Goldman L, Soukup JR, Hayes JG (1993) The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA 269:374–378PubMedCrossRef Laine C, Goldman L, Soukup JR, Hayes JG (1993) The impact of a regulation restricting medical house staff working hours on the quality of patient care. JAMA 269:374–378PubMedCrossRef
36.
Zurück zum Zitat Gottlieb DJ, Parenti CM, Peterson CA, Lofgren RF (1991) Effect of a change in house staff work schedule on resource utilization and patient care. Arch Intern Med 151:2065–2070PubMedCrossRef Gottlieb DJ, Parenti CM, Peterson CA, Lofgren RF (1991) Effect of a change in house staff work schedule on resource utilization and patient care. Arch Intern Med 151:2065–2070PubMedCrossRef
37.
Zurück zum Zitat Keating RJ, LaRusso NF, Kolars JC (2005) Perceived impact of duty hours limits on the fragmentation of patient care: Results from an academic health center. Am J Med 118:788–793PubMedCrossRef Keating RJ, LaRusso NF, Kolars JC (2005) Perceived impact of duty hours limits on the fragmentation of patient care: Results from an academic health center. Am J Med 118:788–793PubMedCrossRef
38.
Zurück zum Zitat Dwyer JP (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):727 Dwyer JP (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):727
39.
Zurück zum Zitat Carr S (2003) Education of senior house officers: current challenges. Postgrad Med J 79:622–626PubMedCrossRef Carr S (2003) Education of senior house officers: current challenges. Postgrad Med J 79:622–626PubMedCrossRef
40.
Zurück zum Zitat Pennell NA, Liu JF, Mazzini MJ (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):726PubMedCrossRef Pennell NA, Liu JF, Mazzini MJ (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):726PubMedCrossRef
41.
Zurück zum Zitat Stickgold R, James L, Hobson JA (2000) Visual discrimination learning requires sleep after training. Nat Neurosci 3:1237–1238PubMedCrossRef Stickgold R, James L, Hobson JA (2000) Visual discrimination learning requires sleep after training. Nat Neurosci 3:1237–1238PubMedCrossRef
42.
Zurück zum Zitat Agrawal J, Rising JP (2002) Resident education and patient safety. Am Fam Physician 66(8):1569–1570PubMed Agrawal J, Rising JP (2002) Resident education and patient safety. Am Fam Physician 66(8):1569–1570PubMed
43.
Zurück zum Zitat Jacques CH, Lynch JC, Samkoff JS (1990) The effects of sleep loss on cognitive performance of resident physicians. J Fam Pract 30:223–229PubMed Jacques CH, Lynch JC, Samkoff JS (1990) The effects of sleep loss on cognitive performance of resident physicians. J Fam Pract 30:223–229PubMed
44.
Zurück zum Zitat Bollschweiler E, Krings A, Fuchs K, Pistorius G, Bein T, Otto U, Muhl E, Backes-Gellner U, Holscher AH (2001) Alternative shift models and the quality of patient care. An empirical study in surgical intensive care units. Langenbecks Arch Surg 386:104–109PubMedCrossRef Bollschweiler E, Krings A, Fuchs K, Pistorius G, Bein T, Otto U, Muhl E, Backes-Gellner U, Holscher AH (2001) Alternative shift models and the quality of patient care. An empirical study in surgical intensive care units. Langenbecks Arch Surg 386:104–109PubMedCrossRef
46.
Zurück zum Zitat Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA (2006) Interns’ compliance with accreditation council for graduate medical education work-hour limits. JAMA 296(9):1063–1070PubMedCrossRef Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA (2006) Interns’ compliance with accreditation council for graduate medical education work-hour limits. JAMA 296(9):1063–1070PubMedCrossRef
47.
Zurück zum Zitat Smith-Coggins R, Howard SK, Mac DT, Wang C, Kwan S, Rosekind MR, Sowb Y, Balise R, Levis J, Gaba DM (2006) Improving alertness and performance in emergency department physicians and nurses: the use of planned naps. Ann Emerg Med 48(5):596–604PubMedCrossRef Smith-Coggins R, Howard SK, Mac DT, Wang C, Kwan S, Rosekind MR, Sowb Y, Balise R, Levis J, Gaba DM (2006) Improving alertness and performance in emergency department physicians and nurses: the use of planned naps. Ann Emerg Med 48(5):596–604PubMedCrossRef
48.
Zurück zum Zitat Landrigan CP, Lockley SW, Czeisler CA (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):728CrossRef Landrigan CP, Lockley SW, Czeisler CA (2005) Interns’ work hours: Correspondence. N Engl J Med 352(7):728CrossRef
Metadaten
Titel
The Impact of Housestaff Fatigue on Occupational and Patient Safety
verfasst von
Scot A. Mountain
Bradley S. Quon
Peter Dodek
Robert Sharpe
Najib T. Ayas
Publikationsdatum
01.08.2007
Verlag
Springer-Verlag
Erschienen in
Lung / Ausgabe 4/2007
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-007-9010-5

Weitere Artikel der Ausgabe 4/2007

Lung 4/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Blutdrucksenkung könnte Uterusmyome verhindern

Frauen mit unbehandelter oder neu auftretender Hypertonie haben ein deutlich erhöhtes Risiko für Uterusmyome. Eine Therapie mit Antihypertensiva geht hingegen mit einer verringerten Inzidenz der gutartigen Tumoren einher.

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.