Extended Shifts Lead to Medical Errors

Surprising approximately no-one outside the medical profession, Eurekalert today features a press release about a paper showing that doctors on long shifts make more mistakes:

The study, published in PLoS Medicine, which was led by Charles Czeisler and Laura Barger from Brigham and Women's Hospital and Harvard Medical School, included 2737 medical residents, who completed 17,003 monthly reports. In months in which residents worked even one long shift-of 24 hours or more -they were three times more likely to report a fatigue-related significant medical error compared with months in which they worked no extended hours. The rate increased to more than -seven-fold higher in months in which more than five extended shifts were worked.

These errors apparently translated into adverse patient events; even in the months in which residents worked one extended shift they were seven times more likely to report an adverse patient event compared with months when no extended shift was worked. In addition, doctors working more than five extended duration shifts per month reported more attentional failures, (i.e., dozing off) during lectures, during ward rounds and during clinical activities, including surgery, and reported 300 percent more fatigue-related preventable adverse events resulting in the death of the patient.

The full paper is available from PLoS Medicine, if you have time to read it. I have to get to a meeting, so I don't, but I wanted to put the link out there.