Impact of resident duty hour limits on safety in the intensive care unit: a national survey of pediatric and neonatal intensivists.
Pediatr Crit Care Med
; 13(5): 578-82, 2012 Sep.
Article
en En
| MEDLINE
| ID: mdl-22614570
ABSTRACT
OBJECTIVE:
Resident duty-hour regulations potentially shift the workload from resident to attending physicians. We sought to understand how current or future regulatory changes might impact safety in academic pediatric and neonatal intensive care units.DESIGN:
Web-based survey.SETTING:
U.S. academic pediatric and neonatal intensive care units.SUBJECTS:
Attending pediatric and neonatal intensivists.INTERVENTIONS:
We evaluated perceptions on four intensive care unit safety-related risk measures potentially affected by current duty-hour regulations 1) attending physician and resident fatigue; 2) attending physician workload; 3) errors (self-reported rates by attending physicians or perceived resident error rates); and 4) safety culture. We also evaluated perceptions of how these risks would change with further duty-hour restrictions. MEASUREMENTS AND MAINRESULTS:
We administered our survey between February and April 2010 to 688 eligible physicians, of whom 360 (52.3%) responded. Most believed that resident error rates were unchanged or worse (91.9%) and safety culture was unchanged or worse (84.4%) with current duty-hour regulations. Of respondents, 61.9% believed their own work-hours providing direct patient care increased and 55.8% believed they were more fatigued while providing direct patient care. Most (85.3%) perceived no increase in their own error rates currently, but in the scenario of further reduction in resident duty-hours, over half (53.3%) believed that safety culture would worsen and a significant proportion (40.3%) believed that their own error rates would increase.CONCLUSIONS:
Pediatric intensivists do not perceive improved patient safety from current resident duty-hour restrictions. Policies to further restrict resident duty-hours should consider unintended consequences of worsening certain aspects of intensive care unit safety.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Admisión y Programación de Personal
/
Médicos
/
Actitud del Personal de Salud
/
Unidades de Cuidado Intensivo Neonatal
/
Errores Médicos
Tipo de estudio:
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
País como asunto:
America do norte
Idioma:
En
Año:
2012
Tipo del documento:
Article