Effect of reducing interns' work hours on serious medical errors in intensive care units
Effect of reducing interns' work hours on serious medical errors in intensive care units
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DOI：
10.1056/nejmoa041406
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发表时间：
2004-10-28
影响因子：
158.5
通讯作者：
Czeisler, CA
中科院分区：
文献类型：
--
作者：
Landrigan, CP;Rothschild, JM;Czeisler, CA
背景：虽然睡眠剥夺已被证明会损害神经行为表现，但很少有研究测量其对医疗差错的影响。方法：我们进行了一项前瞻性随机研究，比较了实习生在按照传统时间表工作时，每隔一班延长（24小时或更长）工作时间（"每三个晚上“的呼叫时间表）和按照干预时间表工作时，他们所犯的严重医疗差错的发生率。通过多学科、四管齐下的办法查明事件，其中包括直接、持续的观察。结果：在总共2203个病人日（涉及634例住院病人）中，实习医生在传统时间表中犯的严重医疗错误比在干预时间表中多35.9%（每1000个病人日136.0对100.1，P
BACKGROUND:Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors.METHODS:We conducted a prospective, randomized study comparing the rates of serious medical errors made by interns while they were working according to a traditional schedule with extended (24 hours or more) work shifts every other shift (an ``every third night'' call schedule) and while they were working according to an intervention schedule that eliminated extended work shifts and reduced the number of hours worked per week. Incidents were identified by means of a multidisciplinary, four-pronged approach that included direct, continuous observation. Two physicians who were unaware of the interns' schedule assignments independently rated each incident.RESULTS:During a total of 2203 patient-days involving 634 admissions, interns made 35.9 percent more serious medical errors during the traditional schedule than during the intervention schedule (136.0 vs. 100.1 per 1000 patient-days, P