Health Brief

STUDY SHOWS EXTENDED PHYSICIAN HOURS CONTRIBUTE TO “ADVERSE PATIENT EVENTS” AND TRIPLE THE RISK OF PATIENT DEATHS

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A new study from a team of researchers shows that doctors working extended shifts are more likely to report medical errors, adverse patient events and attentional failures.

Medical errors can result in what are called “adverse patient events” where patients suffer needless infection, injury, setbacks and even death.

The study, published in PLoS Medicine, included 2,737 medical residents who completed 17,003 monthly reports. For the months in which residents worked even one long shift — of 24 hours or more — they were three times more likely to report a fatigue-related significant medical error than during months they worked no extended hours. The rate of reports increased more than seven-fold higher in months in which more than five extended shifts were worked.

In the months in which residents worked only one extended shift, they were seven times more likely to report an adverse patient event compared with months when no extended shift was worked.

In addition, doctors working more than five extended duration shifts per month reported more attentional failures, such as dozing off during lectures, during ward rounds and during clinical activities, including surgery, and reported three times as many fatigue-related, preventable adverse events resulting in the death of the patient.

Another recent randomized controlled trial in critical care units showed that the elimination of extended duration work shifts greatly reduced the rates of significant medical and attentional failures in that setting.

The authors conclude that, “These results have important public policy implications for post-graduate medical education.”

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SOURCE: http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0030487