Long Hours for Medical Residents Can Result in Medical Errors
Medical residents who work shifts that last 24 hours or longer are at a higher risk of committing harmful or fatal medical errors, according to a study published Tuesday in the journal PLoS Medicine, USA Today reports.
For the study, Harvard Medical School research Charles Czeisler and colleagues surveyed 2,737 first-year medical residents on their work schedules, sleep habits and days off. The residents also were asked to report over the course of the year any errors they made while on duty. The researchers found that when residents worked five "marathon" shifts -- which can last up to 30 hours -- in a month, their risk of making a fatigue-related mistake that harmed a patient increased by 700% and that their risk of making a fatal error increased by 300%.
The residents reported a total 156 fatigue-related errors that harmed a patient and 31 errors that caused patient death.
In July 2003, the Council for Graduate Medical Education limited work schedules to no more than 80 hours per week, but marathon shifts that last up to 30 hours are allowable.
Czeisler said there are about 100,000 medical residents in the U.S. who work these long shifts. He added that his research "suggest[s] there are tens of thousands of preventable injuries to patients annually."
Richard Bell, assistant executive director of the American Board of Surgery, said 24-hour shifts are necessary in some cases to provide continuous care to patients (Fackelmann, USA Today, 12/12).
NPR's "Morning Edition" on Tuesday reported on the study.
The segment includes comments from Stanley Ashley, who runs the surgical training program at Brigham and Women's Hospital; Czeisler; Joseph Fisher, chief of surgery at Beth Israel Deaconness Hospital; and medical residents at Brigham and Women's (Knox, "Morning Edition," NPR, 12/12).
Audio of the segment is available online.