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Student midwives' duty hours: risks, standards, and recommendations.

Rachel Lawrence, Ira Kantrowitz-Gordon, Andrea Landis

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    |March 12, 2014
    PubMed
    Summary

    Extended-duty shifts for student midwives increase risks of errors and decreased quality of life. Evidence-based duty hour limitations are recommended for midwifery education programs to ensure practitioner competence and patient safety.

    Keywords:
    clinical protocolmidwiferypreceptorshipshift-work sleep disordersleepstudents

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    Area of Science:

    • Medical Education
    • Nursing Practice
    • Sleep Science

    Background:

    • Growing evidence highlights risks of extended-duty shifts and sleep deprivation.
    • Midwifery organizations lack standardized duty shift guidelines.
    • This review aims to inform evidence-based recommendations for student midwife duty hours.

    Purpose of the Study:

    • To review literature on extended-duty shifts and sleep deprivation.
    • To develop evidence-based recommendations for student nurse-midwives/student midwives (SNMs/SMs) duty shifts.

    Main Methods:

    • Comprehensive literature search of electronic databases and journals (post-2001).
    • Inclusion of primary research on sleep deprivation and shift duration.
    • Exclusion of studies not including shift workers or exceeding 30-hour shifts.
    • Worldwide review of over 300 healthcare organizations' duty-hour recommendations.

    Main Results:

    • 40 studies met inclusion criteria.
    • Extended shifts (>12 hours) correlate with increased cognitive/physical errors, safety risks, and reduced quality of life.
    • Deficits include attention lapses, slowed reaction times, and increased accident risk (e.g., needle sticks, motor vehicle accidents).
    • Seven organizations recommend duty shift limitations between 12-24 hours for residents/advanced practice nurses.

    Conclusions:

    • Extended-duty shifts may hinder student midwife competence and endanger patients.
    • Midwifery education programs should implement evidence-based duty shift limitations for SNMs/SMs.