Fifteen-hour day shifts have little effect on the performance of taskwork by anaesthesia trainees during uncomplicated clinical simulation.
Anaesth Intensive Care
; 40(6): 1028-34, 2012 Nov.
Article
em En
| MEDLINE
| ID: mdl-23194213
ABSTRACT
Shiftwork and work-hour limits for junior doctors are now well established in hospital work patterns. In order to ensure that trainees have adequate exposure to daytime elective surgical procedures, there is a tendency to have long shifts that include an after-hours component. However, long shifts can cause performance decrement due to time-on-task fatigue. In addition, shifts that encroach upon sleep time result in sleep loss. Using a high-fidelity patient simulation environment, we undertook a randomised, controlled trial to examine fatigue effects. A within-subjects comparison was used to evaluate the effect of 15-hour day shifts on the performance of 12 anaesthesia registrars. Preoperative assessment, machine check and taskwork using 42 task categories were evaluated. In both conditions, there was failure to meet current guidelines for preoperative evaluation or machine check, and when fatigued there was a 'trend' (P=0.06) to a reduction in the number of items in the machine check. With increase in time awake, there was an increase in time taken for explanation to the patient, an increase in mean duration of explanation to the patient, more time looking at the intravenous line or fluids when multi-tasking but less time adjusting the intravenous fluid. These effects are minor during routine uncomplicated induction of anaesthesia, but further investigation is needed to examine fatigue effects during non-routine circumstances.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tolerância ao Trabalho Programado
/
Guias de Prática Clínica como Assunto
/
Fadiga
/
Anestesiologia
Tipo de estudo:
Clinical_trials
/
Guideline
/
Prognostic_studies
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Anaesth Intensive Care
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Nova Zelândia