Impact of Sleep Deficiency on Surgical Performance: A Prospective Assessment

Details

• Personal Author:
  Barger LK ; Buie JD ; Czeisler, Charles A. ; Dominguez C ; Iyer JM ; Landrigan CP ; Majekodunmi A ; Papautsky EL ; Quan SF ; Robbins R ; Shen BH ; Stephens JT ; Weaver MD
• Description:
  Study objectives: Sleep deficiency can adversely affect the performance of resident physicians, resulting in greater medical errors. However, the impact of sleep deficiency on surgical outcomes, particularly among attending surgeons, is less clear. Methods: Sixty attending surgeons from academic and community departments of surgery or obstetrics and gynecology were studied prospectively using direct observation and self-report to explore the effect of sleep deprivation on patient safety, operating room communication, medical errors, and adverse events while operating under 2 conditions, post-call (defined as > 2 hours of nighttime clinical duties) and non-post-call. Results: Each surgeon contributed up to 5 surgical procedures post-call and non-post-call, yielding 362 cases total (150 post-call and 210 non-post-call). Most common were caesarian section and herniorrhaphy. Hours of sleep on the night before the operative procedure were significantly less post-call (4.98 +/- 1.41) vs non-post-call (6.68 +/- 0.88, P < .01). Errors were infrequent and not related to hours of sleep or post-call status. However, Non-Technical Skills for Surgeons ratings demonstrated poorer performance while post-call for situational awareness, decision-making, and communication/teamwork. Fewer hours of sleep also were related to lower ratings for situational awareness and decision-making. Decreased self-reported alertness was observed to be associated with increased procedure time. Conclusions: Sleep deficiency in attending surgeons was not associated with greater errors during procedures performed during the next day. However, procedure time was increased, suggesting that surgeons were able to compensate for sleep loss by working more slowly. Ratings on nontechnical surgical skills were adversely affected by sleep deficiency. [Description provided by NIOSH]
• Subjects:
  Decision Making Health Personnel Occupational Health Safety Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Author Keywords: Attending Surgeon Decision Making Health Care Insufficient Sleep Operating Rooms Physicians Sleep Deficiency Sleep Deprivation Surgeons Surgery Surgical Complications Surgical Outcomes Work Performance Work Schedules

  More +
• ISSN:
  1550-9389
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Illinois ; Massachusetts ; OSHA Region 1 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  19
• Issue:
  4
• NIOSHTIC Number:
  nn:20068267
• Citation:
  J Clin Sleep Med 2023 Apr; 19(4):673-683
• Contact Point Address:
  Stuart F. Quan, MD, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02115 USA
• Email:
  Stuart_Quan@hms.harvard.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  Brigham and Women's Hospital, Boston, Massachusetts
• Peer Reviewed:
  True
• Start Date:
  20190901
• Source Full Name:
  Journal of Clinical Sleep Medicine
• End Date:
  20230831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:394b1186b0180d605b23d9bf563a739bb362244ea9bf9682ea02701f44433133680ae7fc12d4932f7ceb38cccecb4dd346c84dbe79afc0611549f4b7fde0d7ed
• Download URL:
  https://stacks.cdc.gov/view/cdc/230450/cdc_230450_DS1.pdf
• File Type:
  [PDF - 1.63 MB ]