Kort Kara C, Pavone Lucio A, Jensen Eric, Haque Enamul, Newman Nancy, Kittur Dilip
Department of Surgery, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Surgery. 2004 Oct;136(4):861-71. doi: 10.1016/j.surg.2004.07.005.
The Accreditation Council for Graduate Medical Education has recently enacted an 80-hour workweek, which has been in effect in New York State for several years. We surveyed surgical residents from all four State University of New York (SUNY) surgical programs to determine their perceptions of the impact of the 80-hour workweek on patient care, surgical education, and personal life.
A survey instrument to address the three areas of concern was developed and administered to all surgical residents at the four SUNY programs. Anonymity of the responders was maintained. Responses to the questions were in numeric rank scores and were analyzed by descriptive statistics, chi-square analysis, and analysis of variance.
Response rate was 59%. Factors perceived to be affected negatively by the residents were continuity and safety of care, their operative experience, and their relations with attendings. The factors affected positively were increased personal time and decreased fatigue at work. Interestingly, the latter did not appear to decrease the rate of medical errors in their perception.
The 80-hour workweek has the potential to have adverse effects on patient care despite improving the level of fatigue at work. Reengineering the surgical residencies will be needed to take full advantage of the restricted work hours.
毕业后医学教育认证委员会最近颁布了每周80小时的工作制度，该制度在纽约州已经实施数年。我们对纽约州立大学（SUNY）四个外科项目的外科住院医师进行了调查，以确定他们对每周80小时工作制对患者护理、外科教育和个人生活影响的看法。
开发了一种针对三个关注领域的调查问卷，并对SUNY四个项目的所有外科住院医师进行了调查。调查保持了应答者的匿名性。对问题的回答采用数字评分，并用描述性统计、卡方分析和方差分析进行分析。
回复率为59%。住院医师认为受到负面影响的因素包括护理的连续性和安全性、他们的手术经验以及他们与上级医生的关系。受到积极影响的因素是个人时间增加和工作疲劳减轻。有趣的是，在他们看来，后者似乎并没有降低医疗差错率。
尽管每周80小时工作制提高了工作时的疲劳程度，但仍有可能对患者护理产生不利影响。需要对外科住院医师培训进行重新设计，以充分利用受限的工作时间。
