Abstract:
BACKGROUND:Sleep deprivation and fatigue from long-shift work impacts doctors' personal safety, inhibits cognitive performance and risks clinical error. The aim of this study was to assess the sleep quality of surgical trainees participating in European Working Time Directive-compliant training rotations within a UK deanery. METHODS:A trainee cohort numbering 38 (21 core, 17 higher surgical trainees, 29 men and 9 women, median age 31 (25-44 years)) completed a sleep diary over 30 days using the Sleep Time (Azumio) smartphone application and triangulated with on-call rosters to identify shift patterns. The primary outcome measure was sleep quality related to rostered clinical duties. RESULTS:Consecutive 1152 individual sleep episodes were recorded. The median time asleep (hours:min) was 6:29 (5:27-7:19); the median sleep efficiency was 86% (80%-93%); the median light sleep (hours:min) was 2:50 (1:50-3:49); and the median rapid eye movement (REM) sleep (hours:min) was 3:20 (2:37-4:07). Significant adverse sleep profiles were observed in trainees undertaking emergency on-call duty when compared with elective (non-on-call) duty; the median time asleep (hours:min) 5:49 vs 6:43 (p<0.001); the median sleep efficiency was 85% vs 87% (p<0.001); the median light sleep (hours:min) was 2:16 vs 2:58 (p<0.001); and REM sleep (hours:min) was 2:57 vs 3:27 (p<0.001). Recovery of sleep duration, efficiency and quality necessitated five full days of time. CONCLUSION:Surgical emergency on-call duty adversely influences sleep quality. Proper consideration of fail-safe rota design, prioritising sleep hygiene, recovery and well-being, allied to robust patient safety and quality of care should be made a priority.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Brown C,Abdelrahman T,Lewis W,Pollitt J,Egan R,members of the Welsh Surgical Research Initiative.doi
10.1136/postgradmedj-2018-135795subject
Has Abstractpub_date
2020-09-01 00:00:00pages
520-524issue
1139eissn
0032-5473issn
1469-0756pii
postgradmedj-2018-135795journal_volume
96pub_type
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.890.730
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abstract::Small bowel perforation occurs in up to 2 percent of patients with abdominal tuberculous. Patients present with an acute abdomen. Resection of the diseased segment and 18 months treatment with anti-tuberculosis drugs is recommended. ...
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