Ludvigson Adam E, Ryan Stephen T, Gentile Christina R, Mills Gregory J, VerLee Graham T, Hansen Moritz H
J Grad Med Educ. 2018 Oct;10(5):591-595. doi: 10.4300/JGME-D-18-00174.1.
Little research exists regarding factors that contribute to resident fatigue during home call.
We objectively tracked the number and type of pages received, as well as residents' sleep time, during home call. We then examined the relationship between paging volume, resident sleep, and resident fatigue.
A total of 4 of 4 urology residents (100%) at a single institution wore a FitBit Charge HR device from July 2015 to July 2016 to track sleep. Between January and July 2016, pages received by the on-call resident were counted as either (urology inpatient unit), (after-hours answering service), or . Postcall residents were defined as and excused at noon if they reported they were too tired to safely perform clinical duties.
Residents slept an average of 408 minutes per night while not on call, versus 368 minutes while on call but not fatigued, and 181 minutes while on call and fatigued ( < .05). The most senior resident received fewer pages per night on average than the most junior resident. Each page was associated with 4.71 fewer minutes asleep on average for all residents. Pages in the category were associated with 7.74 fewer minutes asleep per page for all residents, but only the most junior resident had significantly less sleep, 9.02 minutes, per page.
Objective sleep data correlate with subjective assessment of resident fatigue and with volume and type of pages received. Senior residents spent less time awake per page and received fewer pages.
关于导致住院医师家庭值班期间疲劳的因素,相关研究较少。
我们客观地追踪了家庭值班期间接到的传呼数量和类型,以及住院医师的睡眠时间。然后,我们研究了传呼量、住院医师睡眠和住院医师疲劳之间的关系。
在一家机构中,共有4名泌尿外科住院医师(100%)在2015年7月至2016年7月期间佩戴FitBit Charge HR设备来追踪睡眠。在2016年1月至7月期间,将值班住院医师接到的传呼分为(泌尿外科住院病房)、(夜间应答服务)或 。交班的住院医师被定义为 ,如果他们报告太累而无法安全履行临床职责,则在中午被免除值班。
住院医师在不值班时平均每晚睡眠408分钟,值班但未疲劳时平均睡眠368分钟,值班且疲劳时平均睡眠181分钟(<0.05)。最年长的住院医师平均每晚接到的传呼比最年轻的住院医师少。所有住院医师平均每接到一次传呼,睡眠时间平均减少4.71分钟。对于所有住院医师来说, 类传呼每一次与睡眠时间减少7.74分钟相关,但只有最年轻的住院医师每 次传呼的睡眠时间显著减少,为9.02分钟。
客观睡眠数据与住院医师疲劳的主观评估以及接到的传呼量和类型相关。年长的住院医师每次传呼时清醒的时间较少,接到的传呼也较少。