Effective Implementation of Work-Hour Limits and Systemic Improvements

Details

• Personal Author:
  Ayas NT ; Barger LK ; Czeisler, Charles A. ; Landrigan CP ; Lockley SW ; Rothschild JM ; Ayas NT ; Barger LK ; Czeisler, Charles A. ; Landrigan CP ; Lockley SW ; Rothschild JM
• Description:
  BACKGROUND: Sleep deprivation, ubiquitous among nurses and physicians, recently has been shown to greatly increase rates of serious medical errors and occupational injuries among health care workers in the United States. CURRENT INITIATIVES AND POLICIES: The Accreditation Council for Graduate Medical Education's current work-hour limits for physicians-in-training allow work hours well in excess of those proven safe. No regulations limit the work hours of other groups of health care providers in the United States. Consequently, nursing work shifts exceeding 12 hours remain common. Physician-in-training shifts of 30 consecutive hours continue to be endorsed officially, and data demonstrate that even the 30-hour limit is exceeded routinely. By contrast, European health care workers are limited by law to 13 consecutive hours of work and to 48-56 hours of work per week. Except for a few institutions that have eliminated 24-hour shifts, as a whole, the United States lags far behind other industrialized nations in ensuring safe work hours. CONCLUSIONS: Preventing health care provider sleep deprivation could be an extremely powerful means of addressing the epidemic of medical errors in the United States. Implementation of evidence-based work-hour limits, scientifically designed work schedules, and infrastructural changes, such as the development of standardized handoff systems, are urgently needed. [Description provided by NIOSH]
• Subjects:
  Health Personnel Occupational Health Safety Safety Management Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Health-care-personnel Medical-personnel Safety-measures Shift-work Shift-workers Sleep-deprivation Statistical-analysis Surveillance-programs Work-intervals Work-performance Work-practices Worker-health

  More +
• ISSN:
  1553-7250
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  19-29
• Volume:
  33
• Issue:
  11
• NIOSHTIC Number:
  nn:20033050
• Citation:
  Jt Comm J Qual Patient Saf 2007 Nov; 33(11 Suppl 1):19-29
• Contact Point Address:
  Christopher P Landrigan, Department of Medicine, Brigham and Women's Hospital, Boston, MA
• Email:
  clandrigan@rics.bwh.harvard.edu
• Federal Fiscal Year:
  2008
• Performing Organization:
  Brigham and Women's Hospital
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  Joint Commission Journal on Quality and Patient Safety
• Supplement:
  1
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:457a4369e748e1b3d30a8f16e6a3cfcb532b073142fffe59f5423fa6f0fc8f6bea8984cd024ecba6315482af8258fb0bffd5b5c6ac625a6da8392f1d9184d00f
• Download URL:
  https://stacks.cdc.gov/view/cdc/188770/cdc_188770_DS1.pdf
• File Type:
  [PDF - 1.66 MB ]