[Fatigue-related risk: what are the consequences for professionals and health-care organizations?]

Many studies have investigated the influence of fatigue on healthcare professionals' safety and clinical performances, showing associations between prolonged work shifts, sleep deprivation and both injuries and errors. Even in the absence of conclusive evidence, after the death of a girl under the care of two fatigued residents, New York State promulgated in 1989 rules to cap residents' duty hours, afterwards adopted by the Accrediting Council for Graduate Medical Education. Italian data on fatigue-related medical errors are still lacking, and no legal cases have raised public awareness of this topic. The authors explored medical-legal issues potentially arising from cases of fatigue-related errors, and proposed two interventions from a risk management perspective: 1. review of events reported through the incident reporting system in which at least one contributing factor was fatigue-related, and 2: root cause analysis of events and accidents reported during night shifts.