Extended Work Shifts and Neurobehavioral Performance in Resident-Physicians.
Adult
Attention
/ physiology
Female
Humans
Intensive Care Units, Pediatric
Internship and Residency
Male
Medical Errors
/ statistics & numerical data
Psychomotor Performance
/ physiology
Shift Work Schedule
/ adverse effects
Sleep Deprivation
/ complications
Sleepiness
Task Performance and Analysis
Time Factors
Wakefulness
/ physiology
Work Schedule Tolerance
/ physiology
Workload
/ psychology
Journal
Pediatrics
ISSN: 1098-4275
Titre abrégé: Pediatrics
Pays: United States
ID NLM: 0376422
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
accepted:
08
12
2020
pubmed:
24
2
2021
medline:
2
7
2021
entrez:
23
2
2021
Statut:
ppublish
Résumé
Extended-duration work rosters (EDWRs) with shifts of 24+ hours impair performance compared with rapid cycling work rosters (RCWRs) that limit shifts to 16 hours in postgraduate year (PGY) 1 resident-physicians. We examined the impact of a RCWR on PGY 2 and PGY 3 resident-physicians. Data from 294 resident-physicians were analyzed from a multicenter clinical trial of 6 US PICUs. Resident-physicians worked 4-week EDWRs with shifts of 24+ hours every third or fourth shift, or an RCWR in which most shifts were ≤16 consecutive hours. Participants completed a daily sleep and work log and the 10-minute Psychomotor Vigilance Task and Karolinska Sleepiness Scale 2 to 5 times per shift approximately once per week as operational demands allowed. Overall, the mean (± SE) number of attentional failures was significantly higher ( Performance impairment due to EDWR is improved by limiting shift duration. These data and their correlation with SME rates highlight the impairment of neurobehavioral performance due to extended-duration shifts and have important implications for patient safety.
Identifiants
pubmed: 33619044
pii: peds.2020-009936
doi: 10.1542/peds.2020-009936
pmc: PMC7919117
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT02134847']
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL128538
Pays : United States
Organisme : NHLBI NIH HHS
ID : K24 HL105664
Pays : United States
Organisme : NIOSH CDC HHS
ID : R01 OH010300
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL114088
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL111478
Pays : United States
Organisme : NIGMS NIH HHS
ID : R01 GM105018
Pays : United States
Organisme : NICHD NIH HHS
ID : R21 HD086392
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01 HL111691
Pays : United States
Organisme : NIA NIH HHS
ID : P01 AG009975
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2021 by the American Academy of Pediatrics.
Déclaration de conflit d'intérêts
POTENTIAL CONFLICT OF INTEREST: All authors have completed the International Committee of Medical Journal Editors uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare the following: no support from any organization for the submitted work, no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.
Références
Ann Emerg Med. 2018 Aug;72(2):171-180
pubmed: 29174830
Prog Brain Res. 2010;185:105-29
pubmed: 21075236
Sleep. 2010 Aug;33(8):1043-53
pubmed: 20815185
J Law Med Ethics. 2013 Spring;41(1):310-4
pubmed: 23581673
N Engl J Med. 2004 Oct 28;351(18):1829-37
pubmed: 15509816
J Grad Med Educ. 2017 Dec;9(6):692-696
pubmed: 29270256
Sleep. 2019 May 1;42(5):
pubmed: 30794317
N Engl J Med. 2019 Jun 13;380(24):2379-2380
pubmed: 31189044
Sleep. 2019 Aug 1;42(8):
pubmed: 31106381
Sleep. 2012 Aug 01;35(8):1137-46
pubmed: 22851809
Sleep. 2018 Feb 1;41(2):
pubmed: 29281091
N Engl J Med. 2004 Oct 28;351(18):1838-48
pubmed: 15509817
J Sleep Res. 2014 Jun;23(3):240-52
pubmed: 24750198
Nat Neurosci. 2013 Feb;16(2):139-45
pubmed: 23354387
Acad Med. 2010 Oct;85(10):1583-8
pubmed: 20881679
N Engl J Med. 2019 Mar 7;380(10):905-914
pubmed: 30855740
N Engl J Med. 2016 Feb 25;374(8):713-27
pubmed: 26836220
Sleep. 2005 Nov;28(11):1392-402
pubmed: 16335329
N Engl J Med. 2020 Jun 25;382(26):2514-2523
pubmed: 32579812
Circulation. 2008 Nov 4;118(19):2005-10
pubmed: 18981315
Contemp Clin Trials. 2019 May;80:22-33
pubmed: 30885799
JAMA. 2005 Sep 7;294(9):1025-33
pubmed: 16145022
J Sleep Res. 1999 Mar;8(1):1-8
pubmed: 10188130
N Engl J Med. 2019 Mar 7;380(10):915-923
pubmed: 30855741
Sleep. 2017 Apr 1;40(4):
pubmed: 28329124
Clin Orthop Relat Res. 2006 Aug;449:116-27
pubmed: 16770285
Sci Rep. 2019 Nov 13;9(1):16681
pubmed: 31723161
Circulation. 2009 Jul 28;120(4):e25
pubmed: 19635976
BMJ. 2001 Nov 24;323(7323):1222-3
pubmed: 11719413
Curr Neurol Neurosci Rep. 2017 Sep 25;17(11):89
pubmed: 28944399