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内科住院医师培训项目中实习医生对夜间轮值制度的看法:亚洲视角

Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective.

作者信息

Tan Benjamin Yong-Qiang, Ngiam Nicholas Jinghao, Chang Zi Yun, Tan Sandra Ming Yien, Shen Xiayan, Mok Shao Feng, Subramanian Srinivas, Ooi Shirley Beng Suat, Kee Adrian Chin-Leong

机构信息

Department of Medicine, National University Health System, Singapore.

Department of Emergency Medicine, National University Health System, Singapore.

出版信息

Korean J Med Educ. 2019 Sep;31(3):271-276. doi: 10.3946/kjme.2019.137. Epub 2019 Aug 26.

Abstract

Long duty hours have been associated with significant medical errors, adverse events, and physician "burn-out". An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors' perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician "burn-out" (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician "burn-out".

摘要

长时间的值班与严重的医疗差错、不良事件以及医生的“职业倦怠”相关。我们在内科项目中实施了一种创新的夜间轮值(NF)系统,以减少与传统全值班系统相关的长时间值班的负面影响。然而,人们仍然担心这是否会导致实习医生培训不足。我们设计了一份结构化问卷,以评估初级医生对NF系统与全值班相比在患者安全、医学培训和幸福感方面的看法。在接受调查的137名医生中,有97名(71%)做出了回应。其中91名(94%)认为NF系统优于全值班系统。绝大多数人认为,与全值班相比,NF对患者安全有益(94%对2%,p<0.001)。NF系统还被认为可以减少医疗差错(94%对2%,p<0.001)和减轻医生的“职业倦怠”(95%对5%,p<0.001)。除了是解决值班时间限制的一个切实可行的办法外,与全值班相比,NF系统在总体满意度、患者安全、减少医疗差错和减轻医生“职业倦怠”方面有明显的益处。

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本文引用的文献

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Internal medicine residency training and outcomes.内科住院医师培训与结果
J Gen Intern Med. 1997 Jun;12(6):390-6. doi: 10.1046/j.1525-1497.1997.00065.x.

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