Systematic Review: Association of Shift Length, Protected Sleep Time, and Night Float With Patient Care, Residents' Health, and Education

2010 ◽  
Vol 153 (12) ◽  
pp. 829 ◽  
Author(s):  
Darcy A. Reed ◽  
Kathlyn E. Fletcher ◽  
Vineet M. Arora
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Sleep Time ◽  
Night Float ◽  
Shift Length

Effects of shift length on quality of patient care and health provider outcomes: systematic review

2009 ◽  
Vol 18 (3) ◽  
pp. 181-188 ◽  
Author(s):  
C A Estabrooks ◽  
G G Cummings ◽  
S A Olivo ◽  
J E Squires ◽  
C Giblin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Health Provider ◽  
Quality Of Patient Care ◽  
Shift Length ◽  
Provider Outcomes

scholarly journals The Effect of Restricting Residents' Duty Hours on Patient Safety, Resident Well-Being, and Resident Education: An Updated Systematic Review

2015 ◽  
Vol 7 (3) ◽  
pp. 349-363 ◽  
Author(s):  
Lauren Bolster ◽  
Liam Rourke
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Resident Education ◽  
Negative Impact ◽  
Well Being ◽  
Duty Hours ◽  
Night Float ◽  
Protected Time ◽  
Resident Wellness ◽  
The Impact

ABSTRACT Background Despite 25 years of implementation and a sizable amount of research, the impact of resident duty hour restrictions on patients and residents still is unclear. Advocates interpret the research as necessitating immediate change; opponents draw competing conclusions. Objective This study updates a systematic review of the literature on duty hour restrictions conducted 1 year prior to the implementation of the Accreditation Council for Graduate Medical Education's 2011 regulations. Methods The review draws on reports catalogued in MEDLINE and PreMEDLINE from 2010 to 2013. Interventions that dealt with the duty hour restrictions included night float, shortened shifts, and protected time for sleep. Outcomes were patient care, resident well-being, and resident education. Studies were excluded if they were not conducted in patient care settings. Results Twenty-seven studies met the inclusion criteria. Most frequently, the studies concluded that the restrictions had no impact on patient care (50%) or resident wellness (47%), and had a negative impact on resident education (64%). Night float was the most frequent means of implementing duty hour restrictions, yet it yielded the highest proportion of unfavorable findings. Conclusions This updated review, including 27 recent applicable studies, demonstrates that focusing on duty hours alone has not resulted in improvements in patient care or resident well-being. The added duty hour restrictions implemented in 2011 appear to have had an unintended negative impact on resident education. New approaches to the issue of physician fatigue and its relationship to patient care and resident education are needed.

Resident-faculty overnight discrepancy rates as a function of number of consecutive nights during a week of night float

Diagnosis ◽  
2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Christine Peterson ◽  
Michael Moore ◽  
Nabeel Sarwani ◽  
Eric Gagnon ◽  
Michael A. Bruno ◽  
...  
Keyword(s):  
Progressive Increase ◽  
Recent Change ◽  
Final Report ◽  
Quality Performance ◽  
Resident Performance ◽  
Night Float ◽  
Perceived Workload ◽  
Report Accuracy ◽  
Shift Length ◽  
The Voice

AbstractObjectivesIn 2018, the ACGME (Accreditation Council for Graduate Medical Education) made a change to the maximum permissible number of consecutive nights a resident trainee can be on “night float,” from six to seven nights. To our knowledge, although investigators have studied overall discrepancy rates and discrepancy rates as a function of shift length or perceived workload of a particular shift, no study has been performed to evaluate resident-faculty discrepancy rates as a quality/performance proxy, to see whether resident performance declines as a function of the number of consecutive nights. Our hypothesis is that we would observe a progressive increase in significant overnight resident – attending discrepancies over the 7 days’ time.MethodsA total of 8,488 reports were extracted between 4/26/2019 to 8/22/2019 retrospectively. Data was obtained from the voice dictation system report server. Exported query was saved as a .csv file format and analyzed using Python packages. A “discrepancy checker” was created to search all finalized reports for the departmental standard heading of “Final Attending Report,” used to specify any significant changes from the preliminary interpretation.ResultsModel estimates varied on different days however there were no trends or patterns to indicate a deterioration in resident performance throughout the week. There were comparable probabilities throughout the week, with 2.17% on Monday, 2.35% on Thursday and 2.05% on Friday.ConclusionsOur results reveal no convincing trend in terms of overnight report discrepancies between the preliminary report generated by the night float resident and the final report issued by a faculty the following morning. These results are in support of the ACGME’s recent change in the permissible number of consecutive nights on night float. We did not prove our hypothesis that resident performance on-call in the domain of report accuracy would diminish over seven consecutive nights while on the night float rotation. Our results found that performance remained fairly uniform over the course of the week.

A Systematic Review of Evidence-Informed Practices for Patient Care Rounds in the ICU*

2013 ◽  
Vol 41 (8) ◽  
pp. 2015-2029 ◽  
Author(s):  
Daniel Lane ◽  
Mauricio Ferri ◽  
Jane Lemaire ◽  
Kevin McLaughlin ◽  
Henry T. Stelfox
Keyword(s):  
Systematic Review ◽  
Patient Care

scholarly journals Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023464 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Care ◽  
Systematic Reviews ◽  
Social Care ◽  
Interdisciplinary Teams ◽  
Cochrane Library ◽  
Early Assessment ◽  
Health And Social Care ◽  
The Impact

IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.

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