The burden of peri-operative work at night as perceived by anaesthesiologists

Abstract

BACKGROUNDNo international data are available on the night working conditions and workload of anaesthesiologists and their opinions about associated risks.OBJECTIVEThe aim of this international survey was to describe the peri-operative night working conditions of anaesthesiologists and their perception of the impact these conditions have on patient outcomes and their own quality of life.DESIGNCross-sectional survey.SETTINGNot applicable.PARTICIPANTSAnaesthesiologists providing peri-operative care during night shifts responded to an online survey promoted by the European Society of Anaesthesiology and Intensive Care (ESAIC).INTERVENTIONSNone.MAIN OUTCOME MEASURETwenty-eight closed questions.RESULTSOverall 5292 complete responses were analysed. Of these, 920 were from trainees. The median reported monthly number of night shifts was 4 [IQR 3–6]. An irregular weekly night shift schedule was most common (51%). Almost all the respondents (98%) declared that their centres have no relevant institutional programmes to monitor stress or fatigue. Most respondents (90%) had received no training or information regarding performance improvement methods for night work. Most respondents were of the opinion that sleep deprivation affects their professional performance (71%) and that their fatigue during night work may increase the peri-operative risk for their patients (74%). Furthermore, 81% of the respondents agreed or strongly agreed that night work represents an additional risk per se for patient safety, and 77% stated that their night work affects the quality of their daily life significantly or extremely.CONCLUSIONAnaesthesiologists commonly perform perioperative night work without appropriate training, education or support on this specific condition. They perceive current practice as adversely affecting their professional performance and the safety of their patients. They also report significant effects on their own quality of life. Adequate training and education for night work may ally some of these concerns and programmes to monitor workers’ stress and fatigue should be mandated to assess whether these concerns are justified.TRIAL REGISTRATIONNot applicable.

Peri-operative night-time work of anaesthesiologists

“…The current data provide an in-depth exploration of the findings described in our quantitative analysis of the survey data. 7 This qualitative study also adds hypotheses and insights to recent literature, already suggesting that perioperative patient outcomes may be affected by the quality of clinical anaesthesia management at night, including redundant preventive treatments (e.g. higher transfusion thresholds) and an increased number of handovers.…”

“…with qualifications and experience similar to those of the participants). The survey was constructed by the researchers as described elsewhere 7 . The data were collected using the online platform REDCap (Research Electronic Data Capture).…”

“…We used a qualitative approach based on thematic analysis and grounded theory principles 9,10 in continuation of our findings from the survey promoted by the European Society of Anaesthesiology and Intensive Care (ESAIC). 7,11 We used a postpositivist approach as we sought to identify perceptions that were generalisable globally. The research group was multinational and comprised of anaesthesiology professionals involved with the ESAIC (i.e.…”

“…The survey was constructed by the researchers as described elsewhere. 7 The data were collected using the online platform REDCap (Research Electronic Data Capture). The only contact between the participants and the researchers was the e-mail letter accompanying the invitations to participate in the survey.…”

“…6 Recent data also suggests that anaesthesiologists believe the current conditions of their night-time practice adversely affect their professional performance, the safety of their patients, and their own quality of life. 7 Many countries have adopted the European Working Time Regulations, thus showing an interest in providing organisational support to night-time workers. However, the peculiarities of healthcare work, including the lack of trained and experienced human resources, may render it difficult to employ solutions commonly used in other settings (e.g.…”