Fear of overtired medical residents may be misplaced. A new study found that residents working 24-hour shifts don’t necessarily make more errors than colleagues working shifts of 16 hours or less.
A study and opinion piece in the New England Journal of Medicine looks at the schedules given to medical residents and the impact of schedules on patient safety.
Medical error is rampant in the practice of medicine in America today. Occurring at all levels of care, medical malpractice happens every day, oftentimes unnoticed, but sometimes with deadly serious consequences for patients and their families.
Resident physicians and their often-grueling work schedules are a prominent example used when discussing fatigue that leads to a host of medical errors. In recent years, scheduling policies for first-year residents have gone back and forth in response to the public conversation about medical fatigue and medical error.
The new NEJM study looked at the length of shifts and the likelihood of medical error in shorter and longer shifts. Over six facilities, researchers evaluated the impact of scheduling on pediatric resident physicians working in intensive care units. Results were obtained by direct observation, close surveillance, and chart review. Here is what they found:
- Residents who worked controlled shifts of less than 24-hours had higher rates of preventable adverse events, made more medical errors, and had more near misses
- Residents working 24-hour or more shifts made fewer medical mistakes despite working longer hours than those who worked less
Digging into the data, study authors found that the three sites with the highest number of errors also had the highest number of patients. Although patient volume was not the focus of the study, it may not be the hour of the night that impacts medical error for residents, but how many patients a physician is driven to see that increases or decreases the number of medical mistakes made on any shift.
While these findings turned over enough data to find that higher patient volume may lead to increased medical error, it will always be true that fatigue and distraction contribute to mistakes and confusion.
Research continues into the ways and means to reduce medical mistakes made by physicians, and other healthcare providers, nursing staff, and institutions. If you suffer medical negligence, speak with our legal team today.
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