Shorter resident shifts may actually increase the number of preventable adverse patient events, according to a study published in the Canadian Medical Association Journal.
The study assessed 47 residents working 12-, 16- and 24-hour shifts at two university-affiliated hospitals in Toronto, Mount Sinai Hospital and St. Michael's Hospital.
Across approximately 800 ICU patients, adverse events were evenly spread: 177 occurred during the 12-hour shifts, 126 in 16-hour shifts and 166 in the 24-hour shifts. However, seven of the eight preventable adverse events occurred during the 12-hour shifts.
This suggests adverse events are not linked to longer shifts when residents might be more tired. In fact, researchers found that though somatic symptoms increased with the number of consecutive hours worked, sleepiness was not statistically different between schedules. Instead, sleepiness was greatest at 4 a.m. across all three schedules, based on the Stanford Sleepiness Scale.
The report suggests the increased turnover in care between residents on shorter shifts provides residents with less clinical and social information about patients, which could result in decreased patient safety.
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