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Patient severity matters for night-shift workload for internal medicine residents in Taiwan

BACKGROUND: Although work hour is an important factors for resident workload, other contributing factors, such as patient severity, with regards to resident workload have been scarcely studied. METHODS: A prospective observational cohort study was conducted in a general medicine unit in an academic...

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Autores principales: Hsu, Nin-Chieh, Yang, Ming-Chin, Chang, Ray-E, Ko, Wen-Je
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260207/
https://www.ncbi.nlm.nih.gov/pubmed/25467773
http://dx.doi.org/10.1186/s12913-014-0587-0
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author Hsu, Nin-Chieh
Yang, Ming-Chin
Chang, Ray-E
Ko, Wen-Je
author_facet Hsu, Nin-Chieh
Yang, Ming-Chin
Chang, Ray-E
Ko, Wen-Je
author_sort Hsu, Nin-Chieh
collection PubMed
description BACKGROUND: Although work hour is an important factors for resident workload, other contributing factors, such as patient severity, with regards to resident workload have been scarcely studied. METHODS: A prospective observational cohort study was conducted in a general medicine unit in an academic medical center in Taiwan. Every event for which the nurses needed to call the on-call residents was recorded. To quantify the workload, the responses of on-duty residents to calls were analyzed. To allow comparisons of patient factors to be made, we classified all patients by assigning them stable, unstable, or do-not-resuscitate (DNR) codes. The reasons for the calls were categorized to facilitate the comparisons across these three groups. RESULTS: From October 2009 to September 2011, a total of 2,518 patients were admitted to the general medicine unit. The nurses recorded a total of 847 calls from 730 call nights, ranging from 0 to 7 per night. Two peaks of calls, at 0-2 am and 6-7 am, were noted. Calls from stable, unstable, and DNR patients were 442 (52.2%), 95 (11.2%), and 298 (35.2%), respectively. For both unstable and DNR patients, the leading reason was abnormal vital signs (62.1% and 67.1%, respectively), while only 36.2% for stable patients. Both unstable and DNR patients required more bedside evaluation and management compared to stable patients. CONCLUSION: Beyond work hours and patient census, patients with different clinical severity and palliative goal produce different workload for on-call residents.
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spelling pubmed-42602072014-12-09 Patient severity matters for night-shift workload for internal medicine residents in Taiwan Hsu, Nin-Chieh Yang, Ming-Chin Chang, Ray-E Ko, Wen-Je BMC Health Serv Res Research Article BACKGROUND: Although work hour is an important factors for resident workload, other contributing factors, such as patient severity, with regards to resident workload have been scarcely studied. METHODS: A prospective observational cohort study was conducted in a general medicine unit in an academic medical center in Taiwan. Every event for which the nurses needed to call the on-call residents was recorded. To quantify the workload, the responses of on-duty residents to calls were analyzed. To allow comparisons of patient factors to be made, we classified all patients by assigning them stable, unstable, or do-not-resuscitate (DNR) codes. The reasons for the calls were categorized to facilitate the comparisons across these three groups. RESULTS: From October 2009 to September 2011, a total of 2,518 patients were admitted to the general medicine unit. The nurses recorded a total of 847 calls from 730 call nights, ranging from 0 to 7 per night. Two peaks of calls, at 0-2 am and 6-7 am, were noted. Calls from stable, unstable, and DNR patients were 442 (52.2%), 95 (11.2%), and 298 (35.2%), respectively. For both unstable and DNR patients, the leading reason was abnormal vital signs (62.1% and 67.1%, respectively), while only 36.2% for stable patients. Both unstable and DNR patients required more bedside evaluation and management compared to stable patients. CONCLUSION: Beyond work hours and patient census, patients with different clinical severity and palliative goal produce different workload for on-call residents. BioMed Central 2014-12-03 /pmc/articles/PMC4260207/ /pubmed/25467773 http://dx.doi.org/10.1186/s12913-014-0587-0 Text en © Hsu et al.; licensee BioMed Central Ltd. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hsu, Nin-Chieh
Yang, Ming-Chin
Chang, Ray-E
Ko, Wen-Je
Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title_full Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title_fullStr Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title_full_unstemmed Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title_short Patient severity matters for night-shift workload for internal medicine residents in Taiwan
title_sort patient severity matters for night-shift workload for internal medicine residents in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260207/
https://www.ncbi.nlm.nih.gov/pubmed/25467773
http://dx.doi.org/10.1186/s12913-014-0587-0
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