Cardiff University, UK.
Cardiff University, UK.
Radiography (Lond). 2024 Jul;30(4):1194-1200. doi: 10.1016/j.radi.2024.05.016. Epub 2024 Jun 19.
Delivering 24 h healthcare requires rotational shift work from doctors and the medical imaging team, while contributing to safe and timely care of patients. Additional service pressure and staff shortfall leads to workload pressures, adjusted shift patterns and risk of burnout. Evidence should be sought to the effects of this work on staff.
This systematic review followed PRISMA reporting guidelines, using a convergent mixed methods approach according to Guidance from Joanna Briggs International. Quantitative trends and results were qualified in order to thematically analyse in conjunction with qualitative data and discussed together in context. Following initial searching, returned articles were screened by title and abstract. A team of 3 reviewers undertook blinded critical appraisal of those suitable, with quality assurance from a 4th team member. Papers passing a threshold of 75% on JBI appraisal tools were accepted for synthesis. Data extraction of appropriate articles retrieved was undertaken in parallel.
Following screening and critical appraisal, 13 studies were returned focusing exclusively on Non Consultant Doctors. No studies investigated diagnostic radiographers. 85% (n = 11) reported negative association between shift work and the three themes of sleep/fatigue, burnout and wellbeing: including after the introduction of shift pattern control or adjusted shift patterns. The remainder showed no change, or any improvement nullified by countermeasures to maintain service delivery.
Current working practices and shift plans in the target population showed detrimental effects on the participants - this can be suggested that Diagnostic Radiographers may suffer fatigue, burnout and poor mental health from stretched shift working patterns.
Further study into the effects of shift work on Diagnostic Radiographers and other allied health professionals is indicated - relating to the above themes in the context of errors and patient safety. Additional research into Non Consultant Doctors, shift work effects and the context of wider service delivery required; with suitable interventions and education to maximise understanding of legal working practices, monitoring and self-management of symptoms.
医生和医学影像团队需要轮班工作以提供 24 小时医疗服务,这有助于为患者提供安全、及时的护理。额外的服务压力和人员短缺导致工作负荷增加、调整轮班模式和出现倦怠风险。应该寻找证据来了解这种工作对员工的影响。
本系统评价遵循 PRISMA 报告指南,根据 Joanna Briggs 国际的指导,采用收敛混合方法。对定量趋势和结果进行限定,以便与定性数据一起进行主题分析,并在上下文中进行讨论。初步搜索后,通过标题和摘要筛选返回的文章。一个由 3 名评审员组成的小组对那些合适的文章进行了盲法批判性评估,由第 4 名小组成员进行质量保证。通过 JBI 评估工具达到 75%阈值的论文被接受进行综合分析。同时对检索到的合适文章进行数据提取。
经过筛选和批判性评估,共返回 13 项专门针对非顾问医生的研究。没有研究调查放射诊断技师。85%(n=11)的研究报告显示,轮班工作与睡眠/疲劳、倦怠和幸福感这三个主题之间存在负面关联:包括在引入轮班模式控制或调整轮班模式后。其余的研究没有显示出变化,或者任何改善都被维持服务提供的对策所抵消。
目标人群的现行工作实践和轮班计划对参与者产生了不利影响——这表明放射诊断技师可能会因轮班工作模式而感到疲劳、倦怠和心理健康不佳。
需要进一步研究轮班工作对放射诊断技师和其他辅助卫生专业人员的影响——涉及上述主题在错误和患者安全方面的背景。需要进一步研究非顾问医生、轮班工作的影响以及更广泛服务提供的背景;并采取适当的干预措施和教育,以最大程度地了解合法工作实践、症状监测和自我管理。