实习生遵守医学研究生教育认证委员会的工作时间限制
Christopher P Landrigan1, Laura K Barger, Brian E Cade
1Harvard Work Hours, Health and Safety Group, Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass 02115, USA. clandrigan@rics.bwh.harvard.edu
JAMA
|September 7, 2006
概括
许多实习生在实施后的第一年违反了医学研究生教育认证委员会 (ACGME) 的工作时间标准. 尽管每周工作时间略有减少,但长班期间的睡眠时间减少,这表明持续的合规问题.
科学领域:
- 医疗教育 医学教育
- 患者安全 患者安全
- 劳动力健康 劳动力健康
背景情况:
- 医疗实习生睡眠不足与医疗错误和事故的增加有关.
- 研究生医学教育认证委员会 (ACGME) 在2003年制定了工作时间标准,以减轻这些风险.
- 评估是否符合这些新标准对于评估其有效性至关重要.
研究的目的:
- 为了估计医疗实习生遵守ACGME工作时间标准的比例.
- 分析ACGME标准实施前后的工作和睡眠时间模式.
主要方法:
- 一项全国前性队列研究调查了4015名在美国居住计划中的实习生.
- 每月的网络调查使用经过验证的仪器评估实习工作和睡眠时间.
- 数据是在实施前 (2002年7月至2003年5月) 和实施后 (2003年7月至2004年5月) 收集的.
主要成果:
- 在实施后,83.6%的实习生报告至少一个月内违反了工作时间标准.
- 实习生的很大比例每周超过80小时 (43.0%),每周缺少一个假日 (43.7%).
- 虽然平均每周工作时间减少,平均睡眠时间略有增加,但在长班期间的睡眠减少.
结论:
- 实习生经常报告在实施后的第一年不遵守ACGME工作时间标准.
- 这些发现凸显了在遵守住院医生规定的工作时间方面存在的持续挑战.
- 需要进一步评估以确保有效实施和对内部人员福祉和患者安全的影响.
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