[2007.5.11][转贴][APTX青山病院]减少工作时间并不能解决年轻医生的疲劳和出错风险

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[U]http://www.medicalnewstoday.com/healthnews.php?newsid=65649[/U]

Cutting Working Hours Won't Solve Junior Doctors' Fatigue And Error Risk

Article Date: 21 Mar 2007 - 1:00 PDT

Cutting the number of hours junior doctors work and providing them more rest breaks won't by itself reduce fatigue or the attendant risk of error, according to a study published ahead of print in Occupational and Environmental Medicine.

An anonymous questionnaire on work patterns, sleepiness and tiredness-related errors was sent to more than 2000 junior doctors. Almost 1,400 responses were received.

The doctors were working 40 or more hours a week in accordance with schedules designed to cut weekly working hours, ensure adequate rest breaks, and reduce the associated risk of errors.

Each participant was given a fatigue risk score by combining 10 aspects of work patterns and sleep in the preceding week. 30% of those who responded were classified as "excessively sleepy" according to a recognised sleepiness scale.

-- One quarter of respondents said that since becoming a doctor they had fallen asleep at the wheel of their car while driving home.

-- Over 60% said they had come close to falling asleep at the wheel during the previous year, and 20% said that this had happened at least five times.

-- The doctors were twice as likely as the general population to score as excessively sleepy, and more than twice as likely to report nearly falling asleep at the wheel as British male drivers.

-- Two thirds said that they had made a mistake associated with fatigue at some point in their careers, while more than four out of 10 said that this had happened in the preceding six months.

-- The higher their fatigue risk score, the higher were the chances that they had nearly fallen asleep while driving and that they had made a mistake in the preceding six months.

-- Night shifts and unscheduled changes to rosters were more consistently linked to sleepiness and errors than the total number of hours worked, after taking account of age and other factors.

-- Conversely, regular access to supervision reduced the likelihood of sleepiness and errors, irrespective of the total hours worked.

The authors said "We conclude that long work hours are not the only aspect of work patterns that needs to be managed to reduce sleepiness and fatigue related clinical errors among junior doctors. The findings support the view that a more comprehensive risk management approach is needed to reduce doctors' sleepiness and improve patient safety."


Cutting Working Hours Won't Solve Junior Doctors' Fatigue And Error Risk
减少工作时间并不能解决年轻医生的疲劳和出错风险

Article Date: 21 Mar 2007 - 1:00 PDT

Cutting the number of hours junior doctors work and providing them more rest breaks won't by itself reduce fatigue or the attendant risk of error, according to a study published ahead of print in Occupational and Environmental Medicine.
依照在《职业与环境医学》中打印前出版的研究，减少年轻医生的工作时间，给他们提供更多的休息机会并不会自己减少疲劳或出错的风险。

An anonymous questionnaire on work patterns, sleepiness and tiredness-related errors was sent to more than 2000 junior doctors. Almost 1,400 responses were received.
一份关于工作模式、困倦和疲劳相关错误的无记名式调查表发给超过2000名年轻医生，收到了将近1400份回执。

The doctors were working 40 or more hours a week in accordance with schedules designed to cut weekly working hours, ensure adequate rest breaks, and reduce the associated risk of errors.
按照为了减少工作时间，确保足够的休息和减少相关的出错风险而制定的时间表，医生每周工作40多个小时。

Each participant was given a fatigue risk score by combining 10 aspects of work patterns and sleep in the preceding week. 30% of those who responded were classified as "excessively sleepy" according to a recognised sleepiness scale.
每个参加者按照结合工作模式的十个方面和前一周的睡眠状况得出一个疲劳危险分数，按照一个公认的困倦状况分级，这些回复者中有30%被分类为“极度困倦”。

-- One quarter of respondents said that since becoming a doctor they had fallen asleep at the wheel of their car while driving home.
四分之一的回复者称成为一名医生以后，他们曾经在驾车回家时睡着过

-- Over 60% said they had come close to falling asleep at the wheel during the previous year, and 20% said that this had happened at least five times.
超过60%称他们在去年曾经在开车时接近睡着，有20%的人称这种情况曾经发生过至少五次。

-- The doctors were twice as likely as the general population to score as excessively sleepy, and more than twice as likely to report nearly falling asleep at the wheel as British male drivers.
医生被评分为极度困倦的几率是普通人的两倍，而在开车时接近睡着的几率是英国男驾驶员的两倍多。

-- Two thirds said that they had made a mistake associated with fatigue at some point in their careers, while more than four out of 10 said that this had happened in the preceding six months.
三分之二的人表示在他们的职业生涯中的某个时间，曾经由于疲劳而犯过错误。超过十分之四的人说在此之前的六个月内曾经出现过这样的事情。

-- The higher their fatigue risk score, the higher were the chances that they had nearly fallen asleep while driving and that they had made a mistake in the preceding six months.
他们的疲劳危险分数越高，他们在开车时接近睡着和他们在过去的六个月内犯错误的几率也就越大。

-- Night shifts and unscheduled changes to rosters were more consistently linked to sleepiness and errors than the total number of hours worked, after taking account of age and other factors.
在考虑了年龄和其它因素后，与总工作时间数相比，值夜班和非计划的改变排班表更能导致困倦和犯错误

-- Conversely, regular access to supervision reduced the likelihood of sleepiness and errors, irrespective of the total hours worked.
相反，定期监督、减少困倦和犯错误的可能性，与总工作时间无关。

The authors said "We conclude that long work hours are not the only aspect of work patterns that needs to be managed to reduce sleepiness and fatigue related clinical errors among junior doctors. The findings support the view that a more comprehensive risk management approach is needed to reduce doctors' sleepiness and improve patient safety."
该作者说：“我们得出结论，为了减少与困倦和疲劳相关的临床错误，长的工作时间并不是工作方式需要更改的唯一方面。这个发现支持 为了减少医生的困倦、提高病人的安全， 需要使用更广泛的危险管理方法 的观点。”

编译：


减少工作时间并不能解决年轻医生的疲劳和出错风险
依照在《职业与环境医学》中打印前出版的研究，减少年轻医生的工作时间，给他们提供更多的休息机会并不会自己减少疲劳或出错的风险。
他们将一份关于工作模式、困倦和疲劳相关错误的无记名式调查表发给超过2000名年轻医生，收到了将近1400份回执。按照为了减少工作时间，确保足够的休息和减少相关的出错风险而制定的时间表，医生每周工作40多个小时。每个参加者按照结合工作模式的十个方面和前一周的睡眠状况得出一个疲劳危险分数，按照一个公认的困倦状况分级，这些回复者中有30%被分类为“极度困倦”。1/4的回复者称成为一名医生以后，他们曾经在驾车回家时睡着过。超过60%称他们在去年曾经在开车时接近睡着，有20%的人称这种情况曾经发生过至少五次。医生被评分为极度困倦的几率是普通人的两倍，而在开车时接近睡着的几率是英国男驾驶员的两倍多。2/3的人表示在他们的职业生涯中的某个时间，曾经由于疲劳而犯过错误。超过4/10的人说在此之前的六个月内曾经出现过这样的事情。他们的疲劳危险分数越高，他们在开车时接近睡着和他们在过去的六个月内犯错误的几率也就越大。在考虑了年龄和其它因素后，与总工作时间数相比，值夜班和非计划的改变排班表更能导致困倦和犯错误。相反，定期监督、减少困倦和犯错误的可能性，与总工作时间无关。
该作者说：“我们得出结论，为了减少与困倦和疲劳相关的临床错误，长的工作时间并不是工作方式需要更改的唯一方面。这个发现支持为了减少医生的困倦、提高病人的安全，需要使用更广泛的危险管理方法的观点。”