دورية أكاديمية
أعرض في EDS

A national survey of out-of-hours working and fatigue in consultants in anaesthesia and paediatric intensive care in the UK and Ireland.

التفاصيل البيبلوغرافية
العنوان: A national survey of out-of-hours working and fatigue in consultants in anaesthesia and paediatric intensive care in the UK and Ireland.
المؤلفون: McClelland L; Department of Intensive Care Medicine and Anaesthesia, Royal Gwent Hospital, Newport, UK., Plunkett E; Department of Anaesthesia, Queen Elizabeth Hospital Birmingham, Birmingham, UK., McCrossan R; Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK., Ferguson K; Department of Anaesthesia, Aberdeen Royal Infirmary, Aberdeen, UK., Fraser J; Department of Paediatric Intensive Care, Bristol Royal Hospital for Children, Bristol, UK., Gildersleve C; Department of Paediatric Anaesthesia, Children's Hospital for Wales, Cardiff, UK., Holland J; Department of Anaesthesia, Princess of Wales Hospital, Bridgend, UK., Lomas JP; Department of Anaesthesia and Intensive Care, Bolton Foundation Trust, Bolton, UK., Redfern N; Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK., Pandit JJ; Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
المصدر: Anaesthesia [Anaesthesia] 2019 Dec; Vol. 74 (12), pp. 1509-1523. Date of Electronic Publication: 2019 Sep 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 0370524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2044 (Electronic) Linking ISSN: 00032409 NLM ISO Abbreviation: Anaesthesia Subsets: MEDLINE
أسماء مطبوعة: Publication: Oxford, UK : Wiley-Blackwell
Original Publication: London, Academic Press; New York, Grune & Stratton.
مواضيع طبية MeSH: Work Schedule Tolerance*, Anesthesiologists/*statistics & numerical data , Critical Care/*statistics & numerical data , Fatigue/*epidemiology , Intensive Care Units, Pediatric/*statistics & numerical data, Adult ; Aged ; Burnout, Professional/epidemiology ; Consultants/statistics & numerical data ; Delphi Technique ; Female ; Health Status ; Humans ; Ireland/epidemiology ; Male ; Middle Aged ; Personnel Staffing and Scheduling ; Sleep ; Surveys and Questionnaires ; United Kingdom/epidemiology
مستخلص: The tragic death of an anaesthetic trainee driving home after a series of night shifts prompted a national survey of fatigue in trainee anaesthetists. This indicated that fatigue was widespread, with significant impact on trainees' health and well-being. Consultants deliver an increasing proportion of patient care resulting in long periods of continuous daytime duty and overnight on-call work, so we wished to investigate their experience of out-of-hours working and the causes and impact of work-related fatigue. We conducted a national survey of consultant anaesthetists and paediatric intensivists in the UK and Ireland between 25 June and 6 August 2018. The response rate was 46% (94% of hospitals were represented): 84% of respondents (95%CI 83.1-84.9%) contribute to a night on-call rota with 32% (30.9-33.1%) working 1:8 or more frequently. Sleep disturbance on-call is common: 47% (45.6-48.4%) typically receive two to three phone calls overnight, and 48% (46.6-49.4%) take 30 min or more to fall back to sleep. Only 15% (14.0-16.0%) reported always achieving 11 h of rest between their on-call and their next clinical duty, as stipulated by the European Working Time Directive. Moreover, 24% (22.8-25.2%) stated that there is no departmental arrangement for covering scheduled clinical duties following a night on-call if they have been in the hospital overnight. Overall, 91% (90.3-91.7%) reported work-related fatigue with over half reporting a moderate or significantly negative impact on health, well-being and home life. We discuss potential explanations for these results and ways to mitigate the effects of fatigue among consultants.
(© 2019 Association of Anaesthetists.)
التعليقات: Comment in: Anaesthesia. 2019 Dec;74(12):1493-1496. (PMID: 31486063)
References: Rogers AE. The effects of fatigue and sleepiness on nurse performance and patient safety. In: Hughes RG ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality, 2008: 1-2.
Scott I. Errors in clinical reasoning: causes and remedial strategies. British Medical Journal 2009; 338: b1860.
Academy of Medical Royal Colleges. The Benefits of Consultant-Delivered Care. 2012. https://www.aomrc.org.uk/wp-content/uploads/2016/05/Benefits_consultant_delivered_care_1112.pdf (accessed 28/07/2019).
British Medical Association. Medical Rota Gaps in England. 2018. https://www.bma.org.uk/collective-voice/influence/key-negotiations/training-and-workforce/medical-rota-gaps-report (accessed 28/07/2019).
Royal College of Physicians. Focus on physicians: 2017-2018 census (UK consultants and higher specialty trainees). 2018. https://www.rcplondon.ac.uk/projects/outputs/focus-physicians-2017-18-census-uk-consultants-and-higher-specialty-trainees (accessed 28/07/2019).
Royal College of Anaesthetists. RCoA Workforce Data Report. 2018. https://www.rcoa.ac.uk/system/files/WorkforceDataPack2018.pdf (accessed 28/07/2019).
The Kings Fund. The health care workforce in England, make or break? 2018. https://www.kingsfund.org.uk/publications/health-care-workforce-england (accessed 28/07/2019).
NHS Survey Coordination Centre. Results from the 2017 staff survey. 2018. https://www.nhsstaffsurveys.com/Page/1100/Past-Results/Staff-Survey-2017-Detailed-Spreadsheets/ (accessed 28/07/2019).
Bernstrom V, Alves D, Ellingsen D, Ingelsrud I. Healthy working time arrangements for healthcare personnel and patients: a systematic literature review. BMC Health Services Research 2019; 19: 193.
McClelland L, Holland J, Lomas J, Redfern N, Plunkett E. A national survey of the effects of fatigue on trainees in anaesthesia in the UK. Anaesthesia 2017; 72: 1069-77.
British Medical Association. The Consultant Handbook 2009. https://www.bma.org.uk/advice/employment/contracts/consultant-contracts/consultant-handbook-england (accessed 28/07/2019).
British Medical Association. Residents on call guidance. 2018. https://www.bma.org.uk/advice/employment/contracts/consultant-contracts/resident-on-call/residents-on-call-guidance (accessed 28/07/2019).
Association of Anaesthetists. Fatigue and Anaesthetists. 2014. https://anaesthetists.org/Home/Resources-publications/Guidelines/Fatigue-and-Anaesthetists (accessed 23/07/2019).
British Medical Association. Fatigue and sleep deprivation. 2018. https://www.bma.org.uk/collective-voice/policy-and-research/education-training-and-workforce/fatigue-and-sleep-deprivation (accessed 28/07/2019).
American College of Obstetricians and Gynaecologists. Committee Opinion. 2018. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Patient-Safety-and-Quality-Improvement/Fatigue-and-Patient-Safety (accessed 28/07/2019).
Sokol DK. Waking up to the effects of fatigue in doctors. British Medical Journal 2013; 347: f4906.
Rimmer A. Urgent action is needed to manage doctors’ fatigue, says BMA. British Medical Journal 2018; 360: k127.
Jankelevitch L, Bunn S. Sleep and long-term health. POSTbrief. Houses of parliament, parliamentary office of science & technology. 2018. https://researchbriefings.parliament.uk/ResearchBriefing/Summary/POST-PB-0029 (accessed 28/07/2019).
Hafner M, Stepanek M, Taylor J, Troxel W, van Stolk C. Why Sleep Matters - The Economic Costs of Insufficient Sleep. A Cross-Country Comparative Analysis. RAND Europe. 2016. https://www.rand.org/content/dam/rand/pubs/research_reports/RR1700/RR1791/RAND_RR1791.pdf (accessed 28/07/2019).
Royal College of Anaesthetists Census (UK data). 2016. https://www.rcoa.ac.uk/system/files/CENSUS-REPORT-2015.pdf (accessed 28/07/2019).
Paediatric Intensive Care Annual Network Annual Report. 2018. https://www.picanet.org.uk/wp-content/uploads/sites/25/2018/12/PICANet_2018_Annual_Report_Tables_and_Figures_v3.0-compressed.pdf (accessed 28/07/2019).
UK Road Traffic Act. 1988. https://www.legislation.gov.uk/ukpga/1988/52/contents (accessed 28/07/2019).
Republic of Ireland Road Traffic Act. 2011. http://www.irishstatutebook.ie/eli/2011/act/28/section/4/enacted/en/html (accessed 28/07/2019).
Cortegiani A, Gregoretti C, Neto AS, et al. Association between night-time surgery and occurrence of intraoperative adverse events and postoperative pulmonary complications. British Journal of Anaesthesia 2019; 122: 361-9.
Folkard S, Tucker P. Shift work, safety and productivity. Occupational Medicine 2003; 53: 95-101.
Sivia DS, Pandit JJ. Mathematical model of the risk of drug error during anaesthesia: the influence of drug choices, injection routes, operation duration and fatigue. Anaesthesia 2019; 74: 992-1000.
Carlisle JB, Merry A. ‘Humanware’: the human in the system. Anaesthesia 2019; 74: 965-8.
Health and Safety Executive. Managing shiftwork. Health and safety guidance. HSG 256. 2006. http://www.hse.gov.uk/pUbns/priced/hsg256.pdf (accessed 28/07/2019).
Centre for Workforce Intelligence. In-depth review of the anaesthetics and intensive care medicine workforce. London, 2015 http://bit.ly/2HdkP58.
Pandit JJ. Pensions, tax and the anaesthetist: significant implications for workforce planning. Anaesthesia 2016; 71: 883-91.
Pandit JJ. Drop a day's work - and lose no pay? On (not) meeting workforce challenges in anaesthetic departments. Bulletin of the Royal College of Anaesthetists 2019; 115: 36-7.
Royal College of Anaesthetists. A report on the morale, welfare and experiences of trainee anaesthetists: the need to listen. 2017. https://www.rcoa.ac.uk/system/files/Welfare-Morale2017.pdf (accessed 28/07/2019).
Skowronski GA, Peisah C. The greying intensivist: ageing and medical practice - everyone's problem. Medical Journal of Australia 2012; 196: 505-7.
Hood S, Shimon A. The aging clock: circadian rhythms and later life. Journal of Clinical Investigation 2017; 127: 437-47.
Association of Anaesthetists. Age and the Anaesthetist. Anaesthesia News 2016; 349: 1-27.
Advisory, Conciliation and Arbitration Service (ACAS). Defining an employer's duty of care. 2012. https://www.acas.org.uk/index.aspx?articleid=3751 (accessed 28/07/2019).
Farquhar M. For nature cannot be fooled. Why we need to talk about fatigue. Anaesthesia 2017; 72: 1069-77.
Health Education England. NHS Staff and Learners’ Mental Wellbeing Commission. 2019. https://www.hee.nhs.uk/sites/default/files/documents/NHS%20%28HEE%29%20-%20Mental%20Wellbeing%20Commission%20Report.pdf (accessed 28/07/2019).
Winter C. Personal sleep monitors: do they work? Huff post contributor blog. 2014. http://www.huffingtonpost.com/dr-christopher-winter/sleep-tips_b_4792760.html (accessed 28/07/2019).
The Sleep Council, Great British Bedtime Survey 2017. https://sleepcouncil.org.uk/wp-content/uploads/2018/04/The-Great-British-Bedtime-Report-2017.pdf (accessed 28/07/2019).
Noone P, Waclawski E. Fatigue risk management systems needed in healthcare. Occupational Medicine 2018; 68: 496-8.
Resident Doctors of Canada. Fatigue Risk Management Toolkit. 2018. https://residentdoctors.ca/wp-content/uploads/2018/11/Fatigue-Risk-Management-ToolkitEN.pdf (accessed 28/07/2019).
Association of Anaesthetists. Fatigue Education Resources. 2018. https://anaesthetists.org/Home/Wellbeing-support/Fatigue/-Fight-Fatigue-download-our-information-packs (accessed 28/07/2019).
Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016. Version 4 2018. https://www.nhsemployers.org/-/media/Employers/Documents/Pay-and-reward/Junior-Doctors/NHS-Doctors-and-Dentists-in-Training-England-TCS-2016-VERSION-4.pdf (accessed 28/07/2019).
Association of Anaesthetists. Fight Fatigue Campaign. 2018. https://anaesthetists.org/Home/Wellbeing-support/Fatigue/Help-Fight-Fatigue (accessed 28/07/2019).
Charles R, Carrick M, Marriott A. An audit of trainee fatigue and wellbeing in the Yorkshire and Humber Deanery. Anaesthesia News 2018; 368: 10-12.
Cronin D, Plastow S, Shinde S. Is it a space shuttle, a sun bed or a sleeping pod? Anaesthesia News 2019; 380: 22-3.
National Freedom to Speak up Guardian. Freedom to Speak Up News. 2018. https://www.cqc.org.uk/sites/default/files/20180111_ngo-newsletter_january2018.pdf (accessed 28/07/2019).
General Medical Council. Training Environments 2018: Key findings from the national training surveys. https://www.gmc-uk.org/-/media/documents/training-environments-2018_pdf-76667101.pdf (accessed 28/07/2019).
معلومات مُعتمدة: Association of Anaesthetists
فهرسة مساهمة: Keywords: consultants; fatigue; on-call; sleep; wellbeing
تواريخ الأحداث: Date Created: 20190904 Date Completed: 20191111 Latest Revision: 20200108
رمز التحديث: 20221213
DOI: 10.1111/anae.14819
PMID: 31478198
قاعدة البيانات: MEDLINE
الوصف
تدمد:1365-2044
DOI:10.1111/anae.14819