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Extended-Duration Shifts for Residents Boost Error Rates

Toughest months associated with higher rates of fatigue-related medical errors and adverse events

THURSDAY, Dec. 14 (HealthDay News) -- Among first-year medical residents, extended-duration working shifts increase the risk of significant medical errors, adverse events and attentional failures, according to a report published online Dec. 11 in PLoS Medicine.

Laura Barger, Ph.D., of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues surveyed 2,737 residents who completed 17,003 monthly reports.

The researchers found that residents were 3.5 times as likely to report at least one significant fatigue-related medical error during months when they worked one to four extended-duration shifts and 7.5 times as likely to report such errors during months when they worked five or more extended-duration shifts than during months when they worked no extended-duration shifts. The researchers also calculated odds ratios for fatigue-related adverse events of 8.7 and 7.0, respectively.

"Restrictions on extended shifts, not just weekly duty-hours, should be considered when designing residents' schedules," according to the author of a related editorial. "This present new study can help inform a more comprehensive approach to patient safety, as called for by the Institute of Medicine."

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