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Sleep-deprived surgeons-in-training at greater risk of error

Any fan of "Grey's Anatomy," "E.R." or "House, M.D." has seen sleep-deprived residents in the hospital halls. While it might make good television drama, it apparently does not make hospital operatories any safer. In fact, two surgical residents at Boston hospitals were reportedly so tired that they spent about 25 percent of their waking hours with sleep-deprived impairment comparable to being drunk.

According to recent study, tired surgical residents are likely to be dangerously tired and could commit surgical or medical errors.

The study was conducted by the Harvard Combined Orthopedic Residency Program in Boston. The study was relatively small - just 27 residents - and was conducted at Massachusetts General Hospital and Brigham And Women's Hospital.

The results were as one might expect and the residents did show impairment due to sleep deprivation. Among the study's findings:

  • Night-shift residents were more impaired than the day-shift residents.
  • Residents averaged 5.3 hours of sleep per day.
  • Night-shift residents were functioning at a 70 percent level or below for 32 percent of the time.
  • Day-shift residents were functioning at a 70 percent level or below 17 percent of the time.

This decrease in functioning level has a predictive error increase rate of 19 percent for the day-shift residents and 24 percent for the night-shift workers. No actual surgical errors were reported during the time-period of the study.

The Accreditation Council for Graduate Medical Education is looking at changing the rules for hours worked by surgical residents. The experts involved in the study suggested targeting tired residents for intervention actions and monitoring the rotation and surgical schedule accordingly.

Should a fatigued surgeon make a surgical error, the hospital and the surgeon may be held liable for damages due to medical malpractice.

Source: Reuters, "Tired surgical residents may up error risk: study," Andrew M. Seaman, May 21, 2012

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