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每周工作48小时对培训机会和与患者接触的影响:爱尔兰实习医生的经历。

Impact of working 48 h per week on opportunities for training and patient contact: the experience of Irish interns.

作者信息

O'Connor Paul, Lydon Sinéad, Offiah Gozie, Ahern Sean, Moloney Brian, Byrne Dara

机构信息

Department of General Practice, National University of Ireland, Distillery Road, Galway, Ireland.

Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland.

出版信息

Int J Qual Health Care. 2015 Dec;27(6):492-8. doi: 10.1093/intqhc/mzv076. Epub 2015 Sep 29.

Abstract

OBJECTIVE

The European Working Time Regulations (EWTR) have been criticized for its purported negative impact on the training of junior doctors. The aim of this study was to examine the amount of time interns spent engaging in various work activities.

DESIGN

An online time-use diary was used to collect data from interns.

SETTING

Two teaching hospitals in the Republic of Ireland.

PARTICIPANTS

A total of 45 interns logged at least one 24-h period. The logs were obtained from 67 shifts from a surgical rotation and 83 shifts from a medical rotation.

MAIN OUTCOME MEASURES

The amount of time interns spent engaging in direct patient care, indirect patient care, educational activities and personal activities.

RESULTS

On day shift, medical interns spent a significantly smaller proportion of the shift on direct care (159/613 min, 25.9% versus 214/636 min, 33.6%) and a greater proportion on education (195/613 min, 31.8% versus 139/636 min, 21.9%) than surgical interns. On extended days, medical interns spent a significantly larger proportion of the shift on education than surgical interns (243/814 min, 29.9% versus 126/804, 15.7% min). On night shift, medical interns spent a significantly greater proportion of the shift on direct care (590/720 min, 81.9% versus 346/727 min, 47.6%) and education (33/720 min, 4.6% versus 6/727 min, 0.8%) than surgical interns.

CONCLUSIONS

The interns in the study reported spending more time on direct patient care and educational activities, and less time on indirect patient care activities than interns in other countries.

摘要

目的

欧洲工作时间法规(EWTR)因其据称对初级医生培训产生的负面影响而受到批评。本研究的目的是调查实习医生参与各种工作活动所花费的时间量。

设计

使用在线时间使用日记从实习医生收集数据。

地点

爱尔兰共和国的两家教学医院。

参与者

共有45名实习医生记录了至少一个24小时时段。这些记录来自外科轮转的67个班次和内科轮转的83个班次。

主要观察指标

实习医生花费在直接患者护理、间接患者护理、教育活动和个人活动上的时间量。

结果

在日班,内科实习医生在直接护理上花费的班次比例显著较小(159/613分钟,25.9%对214/636分钟,33.6%),而在教育上花费的比例更大(195/613分钟,31.8%对139/636分钟,21.9%),比外科实习医生。在延长日,内科实习医生在教育上花费的班次比例显著大于外科实习医生(243/814分钟,29.9%对126/804分钟,15.7%)。在夜班,内科实习医生在直接护理(590/720分钟,81.9%对346/727分钟,47.6%)和教育(33/720分钟,4.6%对6/727分钟,0.8%)上花费的班次比例显著大于外科实习医生。

结论

本研究中的实习医生报告称,与其他国家的实习医生相比,他们在直接患者护理和教育活动上花费的时间更多,而在间接患者护理活动上花费的时间更少。

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