Does Medical Fatigue Lead to Increased Medical Errors?

There's No Substitute for Experience

Surgery is a dangerous event to begin with. However, the possibility for surgical mistakes and errors can raise the risk substantially. Unfortunately, a recent study connects surgical errors to tired residents.

This study found that there are significant risks associated with surgeons in training even after new guidelines have been put in place to limit the work hours of residents. Most recently, first year residents can only work up to 16 hours a day but more experienced residents can work up to 28-hour shifts.

In two Boston area hospitals, orthopedic surgical residents were averaging at most five and a half hours of sleep a night. The range of the amount of sleep each resident got was from less than three hours a night to almost eight.

The effect of their fatigue while they were awake was equivalent to being legally drunk. This means that the study participants were only functioning at about 70 percent of their mental effectiveness. The study found that residents were mentally fatigued almost half of the time they were awake.

Fortunately, residents were only found to be at such a level of fatigue a quarter of the day. But if that time coincides with the resident being in surgery, it could pose a serious risk to the patient.

The study found that residents were 22 percent more likely to cause a medical error than a doctor who is well rested. This is the average of both the day and night shift, but the night shift had a slightly higher risk of making a medical error than the day shift.

The study tried to identify the times when residents were awake when they were most impaired by fatigue. By identifying these times, the researchers determined that they should be able to target interventions directed to surgical residents to prevent medical mistakes.

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