尽管政策不稳定,但方向是一致的:减少住院医生的数量 延长时间的班次超过20年
Matthew D Weaver1, Laura K Barger1, Jason P Sullivan2
1Departments of Medicine and Neurology, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA; Division of Sleep Medicine, Harvard Medical School, Boston, MA.
The American journal of medicine
|January 18, 2025
概括
在过去的20年里,住院医生的长时间轮班显著减少. 与21世纪初相比,第一年居民现在工作的长班次要少得多,这表明了改善工作时间限制的趋势.
科学领域:
- 医学教育 医学教育
- 医生培训 医生培训 医生培训
- 工作时间条例 工作时间条例
背景情况:
- 医生培训涉及苛刻的工作时间表.
- 长时间班次 (EDS) 在医学教育中一直是长期关注的问题.
- 之前的工作时间规定已经多次修订.
研究的目的:
- 分析20多年来在应届医生中延长时间班次 (EDS) 的趋势.
- 为了比较不同培训年和专业的EDS频率.
- 评估修订的工作时间限制对住院医生的日程安排的影响.
主要方法:
- 分析了17498名正在接受培训的医生的工作时间数据.
- 在20年的时间里,对92,662个月的工作进行了审查.
- 在对工作时间限制进行重大修订之前和之后的班次频率的比较.
主要成果:
- 长时间的班次 (≥24小时) 现在比21世纪初少得多.
- 一年级居民目前平均每年4个EDS,工作时每月3个EDS.
- 老年居民也显示EDS频率降低,尽管没有直接受到ACGME指南的限制.
- 外科住院医生和重症监护病房的住院医生比他们的医疗和其他轮换同行更频繁地使用EDS.
结论:
- 工作时间改革导致住院医生的长时间班次大幅减少.
- 在手术和医疗项目之间,以及在不同的轮换中,EDS频率的差异仍然存在.
- 可能需要进一步关注,以解决住院医生工作时间的剩余变化.
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