Fatigue Increases the Risk of Injury from Sharp Devices in Medical Trainees: Results from a Case-Crossover Study

Details

• Personal Author:
  Fisman DN ; Harris AD ; Mittleman MA ; Rubin M ; Sorock, Gary S.
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Fatigue Hazardous Substances Health Care Facilities Workforce And Services Health Personnel Needlestick Injuries Occupational Health Risk Assessment Risk Factors Safety Sleep Sleep Initiation And Maintenance Disorders Staff Development Workplace

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• Keywords:
  Health-care-personnel Health-hazards Medical-care Medical-monitoring Medical-personnel Needlestick-injuries Risk-analysis Risk-factors Sleep-deprivation Training Work-analysis Work-environment Work-practices

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• ISSN:
  0899-823X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; Pennsylvania
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  10-17
• Volume:
  28
• Issue:
  1
• NIOSHTIC Number:
  nn:20031717
• Citation:
  Infect Control Hosp Epidemiol 2007 Jan; 28(1):10-17
• Contact Point Address:
  Drexel University School of Public Health, Philadelphia, PA, 19102
• Email:
  df62@drexel.edu
• Federal Fiscal Year:
  2007
• Performing Organization:
  Beth Israel Deaconess Medical Center
• Peer Reviewed:
  True
• Start Date:
  20020901
• Source Full Name:
  Infection Control and Hospital Epidemiology
• End Date:
  20060831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5c8875c5c44ea09cfb642121ae05f64e4d0e1de9103661427e98b9d48418dcd603cb3a0d48f7108c5e55479941105452f5114c10148c39a173626131c52c2adc
• Download URL:
  https://stacks.cdc.gov/view/cdc/185911/cdc_185911_DS1.pdf
• File Type:
  [PDF - 816.43 KB ]