Scholliers Annelies, Cornelis Stef, Tosi Maurizio, Opsomer Tine, Shaproski David, Vanlersberghe Caroline, Vanhonacker Domien, Poelaert Jan, Goudman Lisa, Moens Maarten
Department of Anaesthesiology and Perioperative Medicine, University Hospital Brussels (UZ Brussel), Brussels, Belgium.
Department of Anaesthesiology and Perioperative Medicine, University Hospital Brussels (UZ Brussel), Brussels, Belgium.
Br J Anaesth. 2023 May;130(5):622-635. doi: 10.1016/j.bja.2022.12.011. Epub 2023 Jan 24.
Recently, fatigue has received more attention as a workplace hazard. This scoping review focuses on fatigue in anaesthesia providers. We explore the prevalence of fatigue in anaesthesia providers, and we examine how fatigue impacts their performance.
A literature search was independently conducted from December 2019 through March 2020. The following four databases were consulted: MEDLINE, CINAHL, EMBASE, and PubPsych. Only studies discussing fatigue in anaesthesia providers were eligible.
The initial database search identified a total of 118 studies, of which 30 studies were included in the review. Eight articles concerned the prevalence of fatigue in anaesthesia providers, whereas 22 explored the impact of fatigue on the performance of anaesthesia providers. Up to 60.8% of anaesthesia providers suffered from severe excessive daytime sleepiness, and fatigue was denoted as a common workplace problem in up to 73.1% of anaesthesia providers. Fatigue had a negative influence on medication errors and vigilance, and it decreased the performance of anaesthesia providers during laboratory psychomotor testing. There was a decrease in non-technical skills (notably communication and teamwork) and worsening mood when fatigued.
Based on this scoping review, fatigue is a prevalent a phenomenon that anaesthesia providers cannot ignore. A combination of deterioration in non-technical skills, increased medication errors, loss of sustained attention, and psychomotor decline can lead to poorer performance and cause patient harm. Concrete strategies to mitigate fatigue should be developed.
最近，疲劳作为一种工作场所危害受到了更多关注。本范围综述聚焦于麻醉从业人员的疲劳问题。我们探讨了麻醉从业人员中疲劳的患病率，并研究了疲劳如何影响他们的工作表现。
于2019年12月至2020年3月独立进行文献检索。查阅了以下四个数据库：医学期刊数据库（MEDLINE）、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）和公共心理学数据库（PubPsych）。只有讨论麻醉从业人员疲劳问题的研究才符合要求。
初步数据库检索共识别出118项研究，其中30项研究纳入本综述。8篇文章涉及麻醉从业人员疲劳的患病率，而22篇探讨了疲劳对麻醉从业人员工作表现的影响。高达60.8%的麻醉从业人员患有严重的日间过度嗜睡，高达73.1%的麻醉从业人员表示疲劳是常见的工作场所问题。疲劳对用药错误和警觉性有负面影响，并且在实验室心理运动测试中降低了麻醉从业人员的表现。疲劳时非技术技能（尤其是沟通和团队合作）会下降，情绪也会变差。
基于本范围综述，疲劳是麻醉从业人员不能忽视的普遍现象。非技术技能的退化、用药错误增加、持续注意力丧失和心理运动能力下降共同作用，会导致工作表现变差并对患者造成伤害。应制定具体的减轻疲劳的策略。
