Thursday, May 24, 2012

The Role Fatigue Plays in Surgical Errors

Whenever anyone goes in for any type of surgical procedure, it’s natural to want to believe that the surgeon involved is well-rested and that fatigue would not be impairing their decisions. And while this may be the case with many surgeons, a recent study looking at first-year surgical residents found the opposite to be a true roughly a quarter of the time. In fact, 27 percent of the time, their fatigue was on par with the mental “impairment” of someone who is intoxicated. Naturally, this level of fatigue also increased their hypothetical chances of making medical mistakes.
The study examined orthopedic surgical residents at two separate hospitals. These residents were initially asked questions related to their sleep and exercise habits, as well as their use of any sedatives, alcohol or other stimulants. In addition, the residents all wore an “actigraphy” type of wristwatch that would record a person’s movement in order to determine their level of activity.
From here, researchers found that on average, residents get roughly five and a half hours of sleep and were only using about 70 percent of their mental effectiveness about a quarter of the time. By only using 70 percent of their mental effectiveness, researchers also found there to be a 22 percent greater risk of them making some sort of a medical mistake than those doctors who had gotten enough rest.
However, when looking at this study and the amount of risk, it is important to note that the risk is a prediction that was based on how tired the residents were. The actual number of medical mistakes was not assessed in this study.
This study was also started in 2010 and went into 2011. During this time, rules were put in place that bars a first-year resident from working longer than a 16 hour shift. And while one can argue that the rule was put in place as a way to try and combat fatigue in the field, researchers from this study point to the fact that there is a good chance that more still needs to be done to prevent fatigue.
Source: Reuters, “Tired surgical residents may up error risk: study,” Andrew M. Seaman, May 21, 2012
Tags: Medical Malpractice, Surgical Error
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