Physicians' Extended Work Shifts Associated With Increased Risk of Medical Errors

First-year doctors-in-training reported that working five extra-long shifts—of 24 hours or more at a time without rest—per month led to a 300 percent increase in their chances of making a fatigue-related preventable adverse event that contributed to the death of a patient, according to a new study. Preventable adverse events are defined as medical errors that cause harm to a patient.

The study carries significant implications for the way first-year residents, or interns, are trained in the United States. Unlike previous studies on interns and fatigue that have suggested a link between resident work hours and medical errors that harmed patients, this study has a sample size large enough to demonstrate that the rate of preventable adverse events grows when interns work shifts of 24 hours or more.

According to the study, interns were three times more likely to report at least one fatigue-related preventable adverse event during months in which they worked between one and four extended-duration shifts. In months in which they worked more than five extended-duration shifts, the doctors were seven times more likely to report at least one fatigue-related preventable adverse event and were also more likely to fall asleep during lectures, rounds, and clinical activities, including surgery.

Read more at http://www.ahrq.gov/news/press/pr2006/extshiftpr.htm