每周80小时工作制对住院医师急诊手术经验的影响。
Impact of the 80-hour work week on resident emergency operative experience.
作者信息
Feanny Mark A, Scott Bradford G, Mattox Kenneth L, Hirshberg Asher
机构信息
Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza #404D, Houston, TX 77030, USA.
出版信息
Am J Surg. 2005 Dec;190(6):947-9. doi: 10.1016/j.amjsurg.2005.08.025.
BACKGROUND
The goal of this study was to analyze the impact of the 80-hour work week on the emergency operative experience of surgical residents.
METHODS
A 2-year retrospective comparison of the operative experience in emergency abdominal procedures of postgraduate year 4 and 5 residents in a city hospital before (group 1) and after (group 2) duty hour restriction.
RESULTS
There was no difference between groups in the mean number of procedures performed as the primary surgeon, but group 2 showed a 40% decrease in technically advanced procedures with a 44% increase in basic procedures. The study also demonstrated a 54% decrease in the operative volume as first assistant. Operative continuity of care by residents decreased from 60% to 26% of cases.
CONCLUSIONS
The ACGME regulatory environment is adversely affecting the emergency operative experience of surgical residents. Our findings underscore the need to develop alternative methods to augment the residents' operative experience.
背景
本研究的目的是分析每周80小时工作制对外科住院医师急诊手术经验的影响。
方法
对一家城市医院4年级和5年级住院医师在值班时间限制之前（第1组）和之后（第2组）的急诊腹部手术操作经验进行为期2年的回顾性比较。
结果
作为主刀医生进行的平均手术例数在两组之间没有差异，但第2组技术难度较高的手术减少了40%，而基本手术增加了44%。该研究还表明，作为第一助手的手术量减少了54%。住院医师的手术连续护理率从60%降至26%。
结论
美国毕业后医学教育认证委员会（ACGME）的监管环境正在对外科住院医师的急诊手术经验产生不利影响。我们的研究结果强调需要开发替代方法来增加住院医师的手术经验。
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