Evaluation of pharmacy resident alertness in an overnight on-call program

Results of a study to determine the impact of overnight on-call duty on pharmacy residents' alertness are presented.

A prospective single-site observational study was conducted to evaluate sleep patterns and alertness levels among pharmacy residents serving 24-hour on-call duty assignments at a large hospital. The study participants (n = 10) wore a wrist actigraph to allow continuous tracking of rest-activity patterns; in addition, study participants completed a validated three-minute psychomotor vigilance test (PVT) during designated time periods around the beginning and the end of each duty shift and several hours after the shift ended. Study participants also documented sleep quality and quantity in a sleep log and self-rated their level of alertness using the Karolinska sleepiness scale (KSS).

Assessments were conducted for a total of 31 on-call duty shifts over one month. Paired comparisons of PVT data obtained at the three assessment periods indicated that on-call duty was not associated with significant changes in PVT performance measures (mean response speed and number of attention lapses). On average, on-call residents rated the quality of sleep during duty assignments as 5 on a 10-point Likert scale.

On-call residents slept for a mean of six hours during overnight duty shifts, with half of the residents reporting sleep interruptions (a mean of 1.73 per shift). PVT results and KSS values indicated no overall decline in resident alertness during the study period.