The effect of physician sleep deprivation on patient safety in perinatal-neonatal medicine.

Recent data indicate that as many as 180,000 patients die each year due to harm suffered as a result of medical care. Between 40 and 60% of these deaths-and the millions of injuries due to medical care-are preventable. In the neonatal intensive care unit (NICU), neonates' size and fragility makes them especially susceptible to serious medical errors, which occur at a far higher rate in this population than elsewhere in hospitals. A growing body of literature demonstrates that the work schedules and sleep deprivation of physicians are important contributors to this epidemic of error. Nowhere is there a higher risk of adverse outcomes due to provider sleep deprivation than in the NICU, where even minor lapses of attention or miscalculations can lead to dire patient outcomes. This review will discuss what is known about how provider sleep deprivation may impact perinatal and neonatal medicine and will discuss ongoing research questions that must be addressed to guide future improvement efforts.