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Abstract
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Question
Does eliminating extended work shifts and reducing the number of hours worked per week reduce serious medical errors made in intensive care units by interns?Study design
Randomised controlled trialMain results
Fewer serious medical errors were made by interns when working hours were reduced (see results table). Fewer serious errors were intercepted and fewer errors affected patients when working hours were reduced. There was no significant difference in the rate of preventable adverse events between the intervention and traditional work schedules. Fewer serious medication errors and diagnostic errors were made by interns during the intervention (reduced hours) schedule compared with the traditional work schedule (serious medication errors: 83 v 100 per 1000 patient-days, p=0.03; diagnostic errors: 3 v 19 per 100 patient-days, p<0.001). There was no significant difference in the rates of serious procedural errors between the two groups. The number of tests interpreted and medications ordered by each group did not differ significantly and error rates among other staff members were not increased. However, interns performed more procedures during the intervention (reduced hours) schedule.Authors' conclusions
Reducing consecutive and weekly working hours significantly reduces medical errors made in intensive care units by interns. This type of scheduling addresses problems caused by sleep deprivation and can significantly improve patient safety. |