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Fatigue increases the risk of injury from sharp devices in medical trainees: results from a case-crossover study.

Authors
Fisman-DN; Harris-AD; Rubin-M; Sorock-GS; Mittleman-MA
Source
Infect Control Hosp Epidemiol 2007 Jan; 28(1):10-17
NIOSHTIC No.
20031717
Abstract
BACKGROUND: Extreme fatigue in medical trainees likely compromises patient safety, but regulations that limit trainee work hours have been controversial. It is not known whether extreme fatigue compromises trainee safety in the healthcare workplace, but evidence of such a relationship would inform the current debate on trainee work practices. Our objective was to evaluate the relationship between fatigue and workplace injury risk among medical trainees and nontrainee healthcare workers. DESIGN: Case-crossover study. SETTING: Five academic medical centers in the United States and Canada. PARTICIPANTS: Healthcare workers reporting to employee healthcare clinics for evaluation of needlestick injuries and other injuries related to sharp instruments and devices (sharps injuries). Consenting workers completed a structured interview about work patterns, time at risk of injury, and frequency of fatigue. RESULTS: Of 350 interviewed subjects, 109 (31%) were medical trainees. Trainees worked more hours per week (P<.001) and slept less the night before an injury (P<.001) than did other healthcare workers. Fatigue increased injury risk in the study population as a whole (incidence rate ratio [IRR], 1.40 [95% confidence interval {CI}, 1.03-1.90]), but this effect was limited to medical trainees (IRR, 2.94 [95% CI, 1.71-5.07]) and was absent for other healthcare workers (IRR, 0.97 [95% CI, 0.66-1.42]) (P=.001).Conclusions. Long work hours and sleep deprivation among medical trainees result in fatigue, which is associated with a 3-fold increase in the risk of sharps injury. Efforts to reduce trainee work hours may result in reduced risk of sharps-related injuries among this group.
Keywords
Needlestick-injuries; Fatigue; Health-care-personnel; Health-hazards; Sleep-deprivation; Work-practices; Work-analysis; Work-environment; Risk-factors; Risk-analysis; Medical-personnel; Medical-monitoring; Medical-care; Training
Contact
Drexel University School of Public Health, Philadelphia, PA, 19102
CODEN
ICEPE3
Publication Date
20070101
Document Type
Journal Article
Email Address
df62@drexel.edu
Funding Type
Grant
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007489
Issue of Publication
1
ISSN
0899-823X
Source Name
Infection Control and Hospital Epidemiology
State
PA
Performing Organization
Beth Israel Deaconess Medical Center
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