The impact of duty hours on resident self reports of errors.
J Gen Intern Med
; 22(2): 205-9, 2007 Feb.
Article
em En
| MEDLINE
| ID: mdl-17356987
ABSTRACT
BACKGROUND:
Resident duty hour limitations aim, in part, to reduce medical errors. Residents' perceptions of the impact of duty hours on errors are unknown.OBJECTIVE:
To determine residents' self-reported contributing factors, frequency, and impact of hours worked on suboptimal care practices and medical errors.DESIGN:
Cross-sectional survey.SUBJECTS:
164 Internal Medicine Residents at the University of California, San Francisco. MEASUREMENTS ANDRESULTS:
Residents were asked to report the frequency and contributing factors of suboptimal care practices and medical errors, and how duty hours impacted these practices and aspects of resident work-life. One hundred twenty-five residents (76%) responded. The most common suboptimal care practices were working while impaired by fatigue and forgetting to transmit information during sign-out. In multivariable models, residents who felt overwhelmed with work (p = 0.02) and who reported spending >50% of their time in nonphysician tasks (p = 0.002) were more likely to report suboptimal care practices. Residents reported work-stress (a composite of fatigue, excessive workload, distractions, stress, and inadequate time) as the most frequent contributing factor to medical errors. In multivariable models, only engaging in suboptimal practices was associated with self-report of higher risk for medical errors (p < 0.001); working more than 80 hours per week was not associated with suboptimal care or errors.CONCLUSION:
Our findings suggest that administrative load and work stressors are more closely associated with resident reports of medical errors than the number of hours work. Efforts to reduce resident duty hours may also need to address the nature of residents' work to reduce errors.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Carga de Trabalho
/
Erros Médicos
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Internato e Residência
Tipo de estudo:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
J Gen Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos