Effects of Sleep Loss and Night Work on Patient Safety

描述：(申请人提供)兰德里根博士是哈佛医学院的儿科学讲师和波士顿儿童医院的医学助理。在儿科实习之后，他完成了健康服务研究方面的团契培训，并获得了公共卫生硕士学位。他目前每年监督3-4个月的普通儿科服务。在剩下的时间里，他从事住院护理质量方面的健康服务研究。他感兴趣的主要领域是医疗差错和家政人员的工作条件。他是AHRQ资助的一项研究的项目负责人，该研究名为“延长工作时间对ICU患者安全的影响”。 兰德里根博士的近期目标是发展有关睡眠不足和夜间睡眠影响的专业知识 致力于病人的安全。他有医疗服务研究和用药错误研究的背景，但需要在睡眠生理学、患者安全和人为因素工程学方面进行进一步培训，以最佳地理解睡眠剥夺与错误的相互作用。他将参加睡眠和昼夜生理学的正式课程，继续在布里格姆妇女医院患者安全中心接受患者安全培训，并将继续接受人类因素工程学方面的高级培训。他将分别接受睡眠剥夺和健康服务研究的国家领导者查尔斯·A·切斯勒博士和唐纳德·A·戈德曼博士的密集指导。他的长期职业目标是1)成为睡眠剥夺、人为因素和医疗差错研究的全国领先者；2)实施和评估改善工作条件和患者安全的战略。兰德里根博士的研究建议是研究实习生的工作安排和睡眠不足对患者安全的影响。使用全面、前瞻性的错误检测方法以及最先进的睡眠测量技术，兰德里根博士将量化一天中的时间、值班时间和睡眠惯性在医疗错误中的作用。这项研究将大大增加 通过确定这些因素中每个因素的相对贡献来了解睡眠和患者的安全，这对于制定适当的疲劳和错误对策将是重要的。这项研究的结果可能对医学实习生的传统呼叫时间表和夜间医院护理的组织具有重要意义。

DESCRIPTION: (provided by applicant) Dr. Landrigan is an Instructor of Pediatrics at Harvard Medical School and an Assistant in Medicine at Children's Hospital, Boston. Following a pediatric residency, he completed fellowship training in health services research and a Master's in Public Health. He currently supervises a general pediatric service for 3-4 months per year. The remainder of the time, he pursues health services research in the quality of inpatient care. His principal areas of interest are medical error and housestaff working conditions. He is a project leader on an AHRQ-funded study, "Effects of Extended Work Hours on ICU Patient Safety." Dr. Landrigan's immediate goal is to develop expertise in the impact of sleep deprivation and night work on patient safety. He has a background in health services research and the study of medication errors, but requires further training in sleep physiology, patient safety, and human factors engineering to optimally understand the interaction of sleep deprivation with error. He will take formal courses in sleep and circadian physiology, will continue training in patient safety at the Center for Patient Safety at the Brigham and Women's Hospital, and will pursue advanced training in human factors engineering. He will receive intensive mentoring by Drs. Charles A. Czeisler and Donald A. Goldmann, national leaders in sleep deprivation and health services research, respectively. His long-term career goals are 1) to become a national leader in the study of sleep deprivation, human factors, and medical error; and 2) to implement and evaluate strategies to improve working conditions and patient safety. Dr. Landrigan's research proposal is to study the manner in which interns' work schedules and sleep deprivation impact patient safety. Using a comprehensive, prospective error detection approach along with state-of-the-art technologies for the measurement of sleep, Dr. Landrigan will quantify the roles of time of day, time on duty, and sleep inertia in medical error. This study will substantially add to the understanding of sleep and patient safety by identifying the relative contributions of each of these factors, which will be important for the development of appropriate fatigue and error countermeasures. The results of this research may have significant implications for the traditional call schedules of medical trainees and the organization of hospital care at night.