Are residents' extended shifts associated with adverse events?
2006

Impact of Extended Shifts on Medical Errors

Sample size: 2737 publication Evidence: moderate

Author Information

Author(s): Mariana Szklo-Coxe

Primary Institution: University of Wisconsin School of Medicine and Public Health

Hypothesis

Are residents' extended shifts associated with adverse events?

Conclusion

Extended shifts for medical interns are linked to increased medical errors and adverse events.

Supporting Evidence

  • Fatigue-related medical errors increased 3.5-fold with one to four extended shifts.
  • Fatigue-related adverse events had odds ratios of 8.7 and 7.0 for different levels of extended shifts.
  • Interns working more than five extended shifts reported more attentional failures.

Takeaway

When doctors work long hours, they make more mistakes that can hurt patients.

Methodology

A nationwide Web-based survey where interns reported their work hours and associated medical errors.

Potential Biases

Interns may have over-attributed errors to fatigue or sleep deprivation.

Limitations

The study may have inflated associations due to how questions about errors were framed.

Participant Demographics

Interns in their first postgraduate year.

Statistical Information

Confidence Interval

95% CI, 3.4–22

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pmed.0030497

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