Institutes for Behavior Resources, Baltimore, MD, USA.
Institutes for Behavior Resources, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Surg. 2021 May;221(5):866-871. doi: 10.1016/j.amjsurg.2020.08.015. Epub 2020 Aug 21.
Sleep loss and fatigue, common in resident physicians, are related to increased medical errors and decreased physician wellbeing. Biomathematical modeling of fatigue can illuminate the relationship between surgical resident fatigue and work scheduling.
General surgery resident schedules were analyzed using the Sleep, Activity, Fatigue and Task Effectiveness model to predict resident performance during work hours. Hypothetical naps were built into the model to assess their effect on predicted performance and fatigue risk.
12 months of duty-hours logged by 89 residents, ranging from post-graduate year (PGY) 1-5, were analyzed. Residents had moderate levels of fatigue risk over 12 month schedules, with at least an 8-h sleep debt during 24.36% of shifts. Performance scores decreased as shift lengths increased. The addition of hypothetical naps increased predicted performance and reduced shift time with fatigue risk.
Biomathematical modeling of resident schedules and predicts a concerning level of fatigue and decreased effectiveness. Naps may improve performance without decreasing scheduled hours.
睡眠不足和疲劳在住院医师中很常见，这与医疗差错增加和医师健康状况下降有关。疲劳的生物数学模型可以阐明外科住院医师疲劳与工作安排之间的关系。
使用睡眠、活动、疲劳和任务效能模型分析普通外科住院医师的日程安排，以预测工作时间内住院医师的表现。该模型中构建了假设性小睡，以评估其对预测表现和疲劳风险的影响。
分析了 89 名住院医师在 12 个月的轮班时间内（从 PGY1 到 PGY5）的数据。住院医师在 12 个月的轮班时间内存在中度的疲劳风险，至少有 24.36%的轮班时间存在 8 小时以上的睡眠债务。随着轮班时间的延长，绩效评分下降。假设性小睡的增加提高了预测表现，并减少了有疲劳风险的轮班时间。
住院医师日程安排的生物数学建模预测了令人担忧的疲劳水平和工作效率下降。小睡可能会提高绩效而不减少规定的工作时间。
