Navigation Links
New Report Recommends Strategies to Reduce Medical Resident Fatigue-Related Errors and Improve Training
Date:12/2/2008

ROCKVILLE, Md., Dec. 2 /PRNewswire-USNewswire/ -- Fatigued medical residents need protected sleep periods and increased supervision of work hour limits to improve patient safety and the training environment, according to a new Institute of Medicine report funded by HHS' Agency for Healthcare Research and Quality.

The report is the result of a 15-month study by an IOM committee that reviewed the relationship between residents' work schedules, their performance and the quality of care they provide. The study confirms that scientific evidence shows acute and chronically fatigued residents are more likely to make mistakes.

The IOM committee recommends several changes to the existing 80-hour-per-week limit on work hours, including protected sleep periods for residents. The Accreditation Council for Graduate Medical Education's current rules allow residents to work a maximum 30-hour shift. In this time, they may treat patients for 24 hours and engage in training or transition activities for the other six hours. The IOM recommends a change to require residents who complete a 30-hour shift to only treat patients for up to 16 hours. They must then have a five-hour protected sleep period between 10 p.m. and 8 a.m., during which time other non-sleeping residents or additional staff members could take over patient care.

"The Institute of Medicine study provides the clear evidence to prove what we have long-believed is true -- fatigue increases the chance for human error," said AHRQ Director Carolyn M. Clancy, M.D. "Most importantly, this report provides solid recommendations that can improve patient safety, as well as increase the quality of the resident training experience."

Other recommendations in the report, Resident Duty Hours: Enhancing Sleep, Supervision, and Safety, include:

  • Increased supervision of work hours. Lack of adherence to limits is common and often underreported. The IOM report recommends periodic independent reviews and strengthened protections for residents and others who report a lack of adherence to current work hour restrictions.

  • Stronger moonlighting restrictions. Current ACGME rules only count internal moonlighting (additional paid health care work at same health care facility) against the 80-hour weekly limit. The IOM report recommends internal and external moonlighting count against the 80-hour weekly limit, because moonlighting outside residency training affects strategically designed periods for rest and sleep, which could reduce residents' readiness for their primary duties.

  • Guaranteed days off to permit adequate recovery after working long shifts. The IOM committee said residents should receive a 24-hour break from duty each week, with one 48- hour break per month, for a total of five days off per month.
  • Reasonable on-call periods. The IOM committee said residents should be on call in the hospital no more than every third night.
  • Safe transportation provided by hospitals to residents who are too fatigued to drive home. AHRQ-funded research shows that residents more than double their risk of driving accidents when they drive home after working extended shifts.
  • Increased resident training on better communication during handovers. Handovers, when clinicians transition care responsibility to other health care providers, are likely to increase with shorter resident shifts. In some cases, multiple handovers could add to the risk for adverse events unless a structured team approach is used.
  • Increased involvement of residents in patient safety activities and adverse event reporting.IOM committee members suggest such involvement could greatly increase the resident's educational experience.

AHRQ has a number of free resources to help residents and other health care providers implement recommendations related to patient safety training and adverse event reporting, including:


'/>"/>
SOURCE Agency for Healthcare Research & Quality
Copyright©2008 PR Newswire.
All rights reserved

Related medicine news :

1. MEDai Evidence-Based Guideline Reporting Provides Decision Support at Point of Care
2. Neovasc Inc. Reports Third Quarter Fiscal Year 2008 Financial Results
3. Dynamics Group AG Publishes Research Report on Senetek
4. Condell Health Network and Medical Center to Pay $36 Million Settlement After Self-Reporting Possible Health-Care Fraud
5. VA Sends Latest Gulf War Illness Report to IOM for Review
6. CRH Medical reports Q3 2008 results
7. Report Shows Progress in Fight Against Cancer, but Congress, States Must Step Up Efforts to Reduce Smoking, Lung Cancer
8. Shamir Optical Industry Ltd. Reports Third Quarter 2008 Results
9. China Nepstar Chain Drugstore Reports Third Quarter 2008 Results
10. Cancer incidence and mortality drops among American men and women, according to annual report
11. Annual report to the nation finds declines in cancer incidence and death rates
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer ... through a fitness app. The fitness app plans to fix the two major problems leading ... a one size fits all type program , They don’t eliminate all the ...
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... Austin residents ... the American College of Mohs Surgery and to Dr. Russell Peckham for medical and ... highly effective treatment for skin cancer. The selective fellowship in Mohs Micrographic Surgery completed ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , ... Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell Farm facility. , ... our new Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First ...
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health ... of their exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards ... at the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced ... feelings, many turn to unhealthy avenues, such as drug or alcohol abuse, as a ... has released tools for healthy coping following a traumatic event. , Trauma sufferers tend ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Roche (SIX: ... 510(k) clearance for its Elecsys BRAHMS PCT (procalcitonin) assay ... sepsis or septic shock. With this clearance, Roche is ... a fully integrated solution for sepsis risk assessment and ... with bacterial infection and PCT levels in blood can ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on ... today announced that patient enrollment in its ongoing ... Duchenne) has exceeded 50% of its 24-patient target. ... in the third quarter of 2016, and to ...
(Date:6/23/2016)... 23, 2016 Bracket , a leading clinical ... generation clinical outcomes platform, Bracket eCOA (SM) 6.0, at ... 26 – 30, 2016 in Philadelphia , ... Outcome Assessment product of its kind to fully integrate with ... Bracket eCOA 6.0 is a flexible platform for electronic clinical ...
Breaking Medicine Technology: