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The Impact of Duty Hours on Resident Self Reports of Errors

BACKGROUND: Resident duty hour limitations aim, in part, to reduce medical errors. Residents’ perceptions of the impact of duty hours on errors are unknown. OBJECTIVE: To determine residents’ self-reported contributing factors, frequency, and impact of hours worked on suboptimal care practices and m...

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Detalles Bibliográficos
Autores principales: Vidyarthi, Arpana R., Auerbach, Andrew D., Wachter, Robert M., Katz, Patricia P.
Formato: Texto
Lenguaje:English
Publicado: Springer-Verlag 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1824755/
https://www.ncbi.nlm.nih.gov/pubmed/17356987
http://dx.doi.org/10.1007/s11606-006-0065-4
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author Vidyarthi, Arpana R.
Auerbach, Andrew D.
Wachter, Robert M.
Katz, Patricia P.
author_facet Vidyarthi, Arpana R.
Auerbach, Andrew D.
Wachter, Robert M.
Katz, Patricia P.
author_sort Vidyarthi, Arpana R.
collection PubMed
description BACKGROUND: Resident duty hour limitations aim, in part, to reduce medical errors. Residents’ perceptions of the impact of duty hours on errors are unknown. OBJECTIVE: To determine residents’ self-reported contributing factors, frequency, and impact of hours worked on suboptimal care practices and medical errors. DESIGN: Cross-sectional survey. SUBJECTS: 164 Internal Medicine Residents at the University of California, San Francisco. MEASUREMENTS AND RESULTS: Residents were asked to report the frequency and contributing factors of suboptimal care practices and medical errors, and how duty hours impacted these practices and aspects of resident work-life. One hundred twenty-five residents (76%) responded. The most common suboptimal care practices were working while impaired by fatigue and forgetting to transmit information during sign-out. In multivariable models, residents who felt overwhelmed with work (p = 0.02) and who reported spending >50% of their time in nonphysician tasks (p = 0.002) were more likely to report suboptimal care practices. Residents reported work-stress (a composite of fatigue, excessive workload, distractions, stress, and inadequate time) as the most frequent contributing factor to medical errors. In multivariable models, only engaging in suboptimal practices was associated with self-report of higher risk for medical errors (p < 0.001); working more than 80 hours per week was not associated with suboptimal care or errors. CONCLUSION: Our findings suggest that administrative load and work stressors are more closely associated with resident reports of medical errors than the number of hours work. Efforts to reduce resident duty hours may also need to address the nature of residents’ work to reduce errors.
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spelling pubmed-18247552007-03-15 The Impact of Duty Hours on Resident Self Reports of Errors Vidyarthi, Arpana R. Auerbach, Andrew D. Wachter, Robert M. Katz, Patricia P. J Gen Intern Med Original Article BACKGROUND: Resident duty hour limitations aim, in part, to reduce medical errors. Residents’ perceptions of the impact of duty hours on errors are unknown. OBJECTIVE: To determine residents’ self-reported contributing factors, frequency, and impact of hours worked on suboptimal care practices and medical errors. DESIGN: Cross-sectional survey. SUBJECTS: 164 Internal Medicine Residents at the University of California, San Francisco. MEASUREMENTS AND RESULTS: Residents were asked to report the frequency and contributing factors of suboptimal care practices and medical errors, and how duty hours impacted these practices and aspects of resident work-life. One hundred twenty-five residents (76%) responded. The most common suboptimal care practices were working while impaired by fatigue and forgetting to transmit information during sign-out. In multivariable models, residents who felt overwhelmed with work (p = 0.02) and who reported spending >50% of their time in nonphysician tasks (p = 0.002) were more likely to report suboptimal care practices. Residents reported work-stress (a composite of fatigue, excessive workload, distractions, stress, and inadequate time) as the most frequent contributing factor to medical errors. In multivariable models, only engaging in suboptimal practices was associated with self-report of higher risk for medical errors (p < 0.001); working more than 80 hours per week was not associated with suboptimal care or errors. CONCLUSION: Our findings suggest that administrative load and work stressors are more closely associated with resident reports of medical errors than the number of hours work. Efforts to reduce resident duty hours may also need to address the nature of residents’ work to reduce errors. Springer-Verlag 2007-01-23 2007-02 /pmc/articles/PMC1824755/ /pubmed/17356987 http://dx.doi.org/10.1007/s11606-006-0065-4 Text en © Society of General Internal Medicine 2007
spellingShingle Original Article
Vidyarthi, Arpana R.
Auerbach, Andrew D.
Wachter, Robert M.
Katz, Patricia P.
The Impact of Duty Hours on Resident Self Reports of Errors
title The Impact of Duty Hours on Resident Self Reports of Errors
title_full The Impact of Duty Hours on Resident Self Reports of Errors
title_fullStr The Impact of Duty Hours on Resident Self Reports of Errors
title_full_unstemmed The Impact of Duty Hours on Resident Self Reports of Errors
title_short The Impact of Duty Hours on Resident Self Reports of Errors
title_sort impact of duty hours on resident self reports of errors
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1824755/
https://www.ncbi.nlm.nih.gov/pubmed/17356987
http://dx.doi.org/10.1007/s11606-006-0065-4
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