A systematic review of sleep deprivation and technical skill in surgery

Whelehan, Dale F.; McCarrick, Cathleen; Ridgway, Paul F.

doi:10.1016/j.surge.2020.01.004

Cited by 27 publications

(24 citation statements)

References 57 publications

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“…Semi-structured, individual interviews were conducted through socially distanced interviewing or online. An empirical interview guide ( Appendix B ), informed by previous research on fatigue in surgeons conducted within the department, 6 , 7 focused on four major themes. The questions focused on four major constructs in the context of the implications of COVID on: 1) work hours and work practice, 2) training and management, 3) system changes and 4) surgeons’ psychology.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 and surgery: A thematic analysis of unintended consequences on performance, practice and surgical training

2021

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Purpose The shift in the national focus and allocation of resources to the management of COVID19 has led to significant changes to surgical practice including the delay of elective surgery. The aim of this study was to explore the implications of such changes on surgeons. Method Using a qualitative study design, semi-structured interviews were conducted with general surgery consultants and non-consultant hospital doctors from a major tertiary hospital in the Dublin region between March–May 2020. Data collection proceeded iteratively using a thematic analysis approach with quality controls such as memoing and collaborative analysis. Results Fourteen surgeons (8 male, 6 female) were interviewed. The majority (n = 11, 78.6%) were NCHDs. Significant themes determined included ‘impacts’ on a variety of constructs such as performance, self-reported fatigue and wellbeing. Training themes elucidated included the effects of the cancellation of elective admissions on reduced operative exposure for trainees. Senior surgical staff were particularly focused on increased complexity in patient management. New policy requirements such as personal protective equipment use and novel rotas have had implications for aspects of work engagement. The pandemic and subsequent national restrictions imposed has afforded opportunities for improved well-being but also resulted in greater solitude in surgeons. Conclusions Rhetoric surrounding fatigue management and virus control dominates the conversation on the relationship between COVID-19 and surgery. Tipping the balance back to parity of fatigue management with service delivery in surgery will be key for sustainability of the surgical workforce.

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Section: Methodsmentioning

confidence: 99%

COVID-19 and surgery: A thematic analysis of unintended consequences on performance, practice and surgical training

2021

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“…19 Studies from Litwiller B et al, Kucharczyk ER et al, Whelehan DF et al, Gates M et al, did not include all high-quality studies probably because research related to sleep deprivation among workers was minimal and were primarily observational studies, with a level of evidence between III to IV. 19,21,22 Research from Whelehan DF et al, Di Muzio M et al (a)., and Kucharczyk ER et al did not apply to heterogeneity analysis because no meta-analysis was done for the data. 20,21,23 The SR and MA from Wagstaff AS et al was a high-quality study and provided risk outcomes in the form of odds ratio (OR), risk ratio (RR), and injury hazard ratio (IHR) for an occupational-related accident.…”

Section: Resultsmentioning

confidence: 99%

The Impact of Sleep Deprivation on Work Performance towards Night-shift Healthcare Workers: An Evidence-based Case Report

et al. 2021

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Background. Poor sleep and excessive fatigue among workers can reduce well-being and physical fitness. However, not many studies have mentioned how sleeping deprivation among night-shift healthcare workers impacted their work performance in multiple aspects. Method. We conducted an evidence-based case report (EBCR) of a night shift nurse who was worried about the impact of her sleep deprivation on her work performance in the future due to prior history of needle-stick injuries. We aimed to determine whether sleeping deprivation caused by regular night shifts leads to decreased work performance among night-shift healthcare workers by formulating a clinical question. Evidence was searched systematically using five major journal databases (Proquest, EBSCO-Host, PubMed, ScienceDirect, and Cochrane) and was assessed thoroughly using inclusion and exclusion criteria. Results. Eleven eligible studies were obtained with a medium level of evidence (III-IV), three systematic reviews with meta-analyses (SR-MA), three SR without MA, and five observational studies. All of them were analyzed and critically appraised using Oxford Evidence-Based Medicine and Joanna Briggs Institute tools. We found that reduced quantity and quality of sleep impacted all dimensions of work performance among healthcare professionals, be it in task performance (e.g., skill proficiency), contextual performance (e.g., communication skill and mental health issues), and patient and health worker safety (accident and medication error). It could also encourage counterproductive work behavior, such as absenteeism. Furthermore, sleep deprivation changes circadian rhythms, causing decreased information processing and affective recognition functions in some vital brain areas, ultimately affecting several work dimensions. Conclusion. In conclusion, stakeholders need to adjust proper shift scheduling for health care workers, practice sleep hygiene, maintain physical fitness, and consume nutritional food, positively correlated to health and productivity.

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“…Revisão sistemática conduzida na Irlanda, que analisou 33 estudos, identificou que a privação do sono afetou a habilidade técnica em cirurgiões entre 11,9% e 32%, com impacto negativo em ambiente simulado, padronizado com prováveis implicações clínicas para segurança do paciente (20) . Outros fatores interferem negativamente na adesão aos itens do Checklist, dentre estes, a escassez de treinamentos e avaliações que podem ajudar a identificar problemas, e variações na implantação e prática dos profissionais (15) .…”

Section: Discussionunclassified

Compliance with the Cesarean Surgical Safety Checklis

2020

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Objective: to verify compliance with the procedures of health teams in cesarean surgery. Methods: cross-sectional, descriptive and analytical study, performed in an Obstetric Center of a public hospital, with 220 cesarean surgeries. The Tukey test and the Analysis of Variance were used, considering a significance of 5%. Results: the mean age of the patients was 28.8 years (± 6.06). The main indications for cesarean surgery were: fetal distress (12.8%), gestational diabetes (9.5%), interactivity (9.2%), previous cesarean surgery (8.2%) and severe pre-eclampsia (5.9 %). There was an absence of unified conduct and incipient communication among professionals. The compliance rates of the teams’ compliance with the items in the Checklist for Dimensions A, B and C were, respectively, 36.0%, 11.1% and 50.0%. Conclusion: there was a low compliance of teams to surgical safety procedures in cesarean surgeries.

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A systematic review of sleep deprivation and technical skill in surgery

Cited by 27 publications

References 57 publications

COVID-19 and surgery: A thematic analysis of unintended consequences on performance, practice and surgical training

COVID-19 and surgery: A thematic analysis of unintended consequences on performance, practice and surgical training

The Impact of Sleep Deprivation on Work Performance towards Night-shift Healthcare Workers: An Evidence-based Case Report

Compliance with the Cesarean Surgical Safety Checklis

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