Extended Shifts for Medical Interns Negatively Impact Patient Safety

By American Academy of Sleep Medicine,

Working an extended duration shift can pose a risk to not only the safety and well-being of medical interns, but also to that of their patients.

The study, authored by Laura Barger, PhD, of Brigham and Women's Hospital in Boston, was based on 2,737 physicians in their first post-graduate year, who participated in a nationwide Web-based survey, completing a total of 17,003 monthly reports. A regression analysis was performed to determine the relationship between the number of extended duration work shifts (greater than or equal to 24 hours in length), reported medical errors and a self-reported measure of stress.

It was discovered that the reporting of medical errors and the number of extended duration shifts worked in a month were both significant predictors of stress. Compared to months in which no extended duration shifts were worked, interns working five or more extended duration shifts had seven times greater odds of reporting at least one fatigue-related significant medical error that resulted in an adverse patient event and reported 300 percent more fatigue-related preventable adverse events resulting in the death of the patient. Moreover, interns who reported a medical error that resulted in an adverse patient outcome were more than three times as likely to report high stress in that month.

These results suggest that extended duration shifts negatively impact patient safety and the well-being of medical interns. They have important public policy implications for post-graduate medical education and suggest the need for counseling or other care for interns who make medical errors, said Barger.

The amount of sleep a person gets affects his or her physical health, emotional well-being, mental abilities, productivity and performance. Recent studies associate lack of sleep with serious health problems such as an increased risk of depression, obesity, cardiovascular disease and diabetes.

Experts recommend that adults get between seven and eight hours of sleep each night to maintain good health and optimum performance.