Gupta Ronish, Eady Kaylee, Moreau Katherine, Frank Jason R, Writer Hilary K
Department of Pediatrics, University of Ottawa, Ottawa, Ontario.
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario.
Paediatr Child Health. 2019 Jul 11;25(7):467-472. doi: 10.1093/pch/pxz092. eCollection 2020 Nov.
Resident duty hours remain a controversial topic in the literature. Competing interests include patient safety, resident education, and resident well-being. No studies, however, have sought family members' perspectives on duty hours in the paediatric context. This study aimed to explore family members' knowledge of trainee duty hours, and their perspectives on the balance between shift duration and hand-off frequency.
We surveyed family members of patients admitted ≥ 24 hours in the paediatric intensive care unit at an academic center. We simultaneously collected daily logs of hours worked by trainees. Descriptive statistics were used to analyze survey responses and trainee duty hours.
One-hundred and one family members responded (75%). Respondents demonstrated knowledge of trainees working long duty hours but reported lower averages than the trainee logs (55 versus 66 hours per week and 16 versus 24 hours per shift). Elements related to both potential trainee fatigue and hand-offs raised concern in more than half of respondents. When asked to choose between a familiar trainee working a prolonged shift, or an unfamiliar trainee at the start of their shift, respondents were divided (52% versus 48%, respectively).
Family members of critically ill paediatric patients are aware that trainees provide patient care while working long duty hours with minimal sleep. Despite this awareness, long shifts retain value with some families, possibly due to continuity. Changes to duty hours and hand-off frequency may pose an unrealized harm on family-centered care, as well as patient-provider relationships, and further study is warranted.
住院医师值班时长在文献中仍是一个颇具争议的话题。相互冲突的利益包括患者安全、住院医师教育以及住院医师的福祉。然而，尚无研究探寻家庭成员对儿科环境中值班时长的看法。本研究旨在探究家庭成员对实习医生值班时长的了解，以及他们对轮班时长与交接班频率之间平衡的看法。
我们对一家学术中心儿科重症监护病房住院时间≥24小时的患者家属进行了调查。我们同时收集了实习医生的每日工作时长记录。采用描述性统计分析调查回复和实习医生值班时长。
101名家庭成员做出回应（回应率为75%）。受访者知晓实习医生值班时间长，但报告的平均时长低于实习医生的记录（每周55小时对66小时，每班16小时对24小时）。超过半数的受访者对与实习医生潜在疲劳和交接班相关的因素表示担忧。当被要求在熟悉的实习医生延长班次和刚开始轮班的不熟悉实习医生之间做出选择时，受访者意见不一（分别为52%对48%）。
重症儿科患者的家庭成员意识到实习医生在值班时间长且睡眠极少的情况下提供患者护理。尽管有这种认识，但长时间轮班对一些家庭仍有价值，可能是由于连续性。值班时长和交接班频率的改变可能对以家庭为中心的护理以及患者与医护人员的关系造成未被认识到的损害，因此有必要进行进一步研究。
