Davis S J, McDonald S
ENT Department, Queen Alexandra Hospital, Portsmouth, UK.
J Laryngol Otol. 2006 Jul;120(7):587-90. doi: 10.1017/S0022215106001071. Epub 2006 May 4.
The implementation of the European working time directive has led to an increase in cross-speciality out-of-hours cover. This survey illustrates ENT out-of-hours cover arrangements and assesses the implications for senior house officers (SHOs) responsible for managing emergencies.
A telephone survey of 100 ENT departments was conducted, asking the on-call SHO about departmental structure, on-call rota design, their previous ENT experience, access to SHO training and their confidence in managing emergencies.
44 per cent of departments used only ENT SHOs on the on-call rota. 73 per cent always had an ENT middle grade on call. In 60 per cent of hospitals, the ENT consultant was sometimes on call with only a non-ENT SHO. At the time of the study, 5 per cent of SHOs had no ENT experience, no access to training, were not confident in managing simple emergencies and were on-call without middle-grade cover.
The current junior on-call structure for ENT has implications for patient management.
欧洲工作时间指令的实施导致跨专业非工作时间值班有所增加。本次调查阐明了耳鼻喉科非工作时间的值班安排,并评估了对负责处理紧急情况的住院医师的影响。
对100个耳鼻喉科进行了电话调查,询问值班住院医师有关科室结构、值班轮值表设计、他们之前的耳鼻喉科经验、接受住院医师培训的机会以及他们处理紧急情况的信心。
44%的科室在值班轮值表上仅安排耳鼻喉科住院医师。73%的科室始终有一名耳鼻喉科中级职称人员随时待命。在60%的医院中,耳鼻喉科顾问有时仅与一名非耳鼻喉科住院医师一起值班。在研究期间,5%的住院医师没有耳鼻喉科经验,无法接受培训,对处理简单紧急情况缺乏信心,并且在没有中级职称人员掩护的情况下值班。
当前耳鼻喉科初级值班结构对患者管理有影响。