Department of Internal Medicine and Neurology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio.
Wright-Patterson Air Force Base Medical Center, Ohio.
J Clin Sleep Med. 2023 May 1;19(5):935-940. doi: 10.5664/jcsm.10480.
To identify sleep strategies of internal medicine residents transitioning to night shift and report their effect on performance.
Residents logged hours of sleep and work starting 3 days prior to the first night shift and continuing through the next 8 days. Cohorts were defined by sleep logs and compared separately by transition strategy, total hours of sleep, amount of sleep occurring at work, weekend sleep schedule, and residency training year. Data from logs were entered into the Fatigue Avoidance Scheduling Tool to measure predicted Performance Effectiveness (PE) during each night shift.
Twenty-three residents were evaluated. The Sleep Banking transition strategy (n = 2) had higher PE (mean = 88.6%) than all other sleep strategies combined (n = 21, mean = 80.9%; = .016). Additionally, residents who slept an average of 8-9 hours daily during their week of night shifts had a higher mean PE compared to those who slept < 6 hours (86.8% vs 78.6%; = .014).
Residents who engaged in Sleep Banking prior to the first night shift had higher PE and spent less time above a 0.05% blood alcohol concentration equivalent compared to all other strategies. Similarly, PE and time spent above a 0.05% blood alcohol concentration equivalent improved with increased average hours slept per day during the week of night shifts. Optimizing performance on night shift through the adoption of efficacious sleep strategies is imperative to mitigate patient safety issues that may result from poor alertness and cognitive abilities.
Cushman P, Scheuller HS, Cushman J, Markert RJ. Improving performance on night shift: a study of resident sleep strategies. . 2023;19(5):935-940.
确定内科住院医师轮夜班时的睡眠策略，并报告其对表现的影响。
住院医师在第一个夜班前 3 天开始记录睡眠时间和工作时间，并持续到接下来的 8 天。根据睡眠记录将队列定义，并分别根据过渡策略、总睡眠时间、工作时的睡眠时间、周末睡眠时间表和住院医师培训年限进行比较。从日志中获取的数据输入到疲劳避免排班工具中，以衡量每个夜班的预测绩效效果（PE）。
评估了 23 名住院医师。睡眠储备（Sleep Banking）过渡策略（n = 2）的 PE（平均值 = 88.6%）高于所有其他睡眠策略的组合（n = 21，平均值 = 80.9%；=.016）。此外，在夜班周内每天平均睡眠 8-9 小时的住院医师的平均 PE 高于睡眠<6 小时的住院医师（86.8%比 78.6%；=.014）。
与所有其他策略相比，在第一个夜班前采用睡眠储备策略的住院医师的 PE 更高，并且花费在血液酒精浓度等效值超过 0.05%的时间更少。同样，随着夜班周内平均每天睡眠时间的增加，PE 和花费在血液酒精浓度等效值超过 0.05%的时间也得到了改善。通过采用有效的睡眠策略来优化夜班表现对于减轻因警觉性和认知能力下降而导致的患者安全问题至关重要。
Cushman P, Scheuller HS, Cushman J, Markert RJ。通过采用有效的睡眠策略来提高夜间工作的绩效：对住院医师睡眠策略的研究。。2023;19(5):935-940。
