The fatigued anesthesiologist: A threat to patient safety?

Sinha, Ashish; Singh, Avtar; Tewari, Anurag

doi:10.4103/0970-9185.111657

Cited by 48 publications

(41 citation statements)

References 50 publications

(56 reference statements)

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“…Fewer fatigued providers on the day shift may have lowered mortality. 2728 Second, during this study we placed significant educational emphasis on the need to monitor patient outcomes and modify clinical practice to improve outcomes. It is possible that emphasis on monitoring and improving outcome metrics engendered increased vigilance and more diligent care during each case.…”

Section: Discussionmentioning

confidence: 99%

Monitoring Anesthesia Care Delivery and Perioperative Mortality in Kenya Utilizing a Provider-driven Novel Data Collection Tool

et al. 2017

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Background Perioperative mortality rate is regarded as a credible quality and safety indicator of perioperative care, but its documentation in low- and middle-income countries is poor. We developed and tested an electronic, provider report–driven method in an East African country. Methods We deployed a data collection tool in a Kenyan tertiary referral hospital that collects case-specific perioperative data, with asynchronous automatic transmission to central servers. Cases not captured by the tool (nonobserved) were collected manually for the last two quarters of the data collection period. We created logistic regression models to analyze the impact of procedure type on mortality. Results Between January 2014 and September 2015, 8,419 cases out of 11,875 were captured. Quarterly data capture rates ranged from 423 (26%) to 1,663 (93%) in the last quarter. There were 93 deaths (1.53%) reported at 7 days. Compared with four deaths (0.53%) in cesarean delivery, general surgery (n = 42 [3.65%]; odds ratio = 15.80 [95% CI, 5.20 to 48.10]; P < 0.001), neurosurgery (n = 19 [2.41%]; odds ratio = 14.08 [95% CI, 4.12 to 48.10]; P < 0.001), and emergency surgery (n = 25 [3.63%]; odds ratio = 4.40 [95% CI, 2.46 to 7.86]; P < 0.001) carried higher risks of mortality. The nonobserved group did not differ from electronically captured cases in 7-day mortality (n = 1 [0.23%] vs. n = 16 [0.58%]; odds ratio =3.95 [95% CI, 0.41 to 38.20]; P = 0.24). Conclusions We created a simple solution for high-volume, prospective electronic collection of perioperative data in a lower- to middle-income setting. We successfully used the tool to collect a large repository of cases from a single center in Kenya and observed mortality rate differences between surgery types.

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Section: Discussionmentioning

confidence: 99%

Monitoring Anesthesia Care Delivery and Perioperative Mortality in Kenya Utilizing a Provider-driven Novel Data Collection Tool

et al. 2017

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“…Healthcare professions are of high sensitivity in nature due to concerns around patient's safety in the hospitals, increasing probability of human errors in tired personnel as well as and weak psychomotor and cognitive performance. (17,18). Moreover, the increased workload can increase job pressures and cause difficulties in the decision making process in the healthcare personnel.…”

Section: Introductionmentioning

confidence: 99%

Mental workload and its association with fatigue in operating room personnel of Hamadan hospitals, Iran, 2016

Motamedzade

Abbasinia

Parvari

et al. 2017

JOHE

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Received: May 2017, Accepted: July 2017 Background: Fatigue in the workers reduces the individual's resistance and eventually leads to the lower performance, increased errors and accidents. This study assessed the fatigue, mental workload and the correlation between them, in operating room personnel of Hamadan hospitals, Iran. Materials and Methods: In a descriptive study, the mental workload and its association with fatigue in operating room personnel were investigated. Total of 188 cases including surgeons, nurses, operating room and anesthesia technicians participated in the study. Data were collected using demographic, fatigue and mental workload questionnaires, and were analyzed using SPSS software. Results: The mean of overall mental workload was 74.3 ± 10.8. The results also showed that overall fatigue and its domains, including subjective fatigue, concentration, motivation and physical activity were 48.73%, 54.31%, 51.65%, 38.96% and 42.06%, respectively. Among different domains of mental workload, performance (r = -0.380, P < 0.001) and frustration (r = 0.222, P = 0.014) were significantly associated with overall fatigue. Between overall mental workload and overall fatigue, there was not a significant correlation (r = 0.029, P = 0.749). Among different dimensions of fatigue, only subjective fatigue was correlated with mental workload (r = 0.255, P = 0. 005). Conclusions: Regarding the association of performance and the frustration with overall fatigue and the association of overall mental workload with subjective fatigue, it can be concluded that mental workload and fatigue may be correlated with each other. Therefore, any reduction in mental workload domains may lead to fatigue reduction in the operating room personnel.

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“…Hal ini dapat berimplikasi terhadap gangguan dalam mengambil keputusan, mempengaruhi daya ingat, terlambatnya atau tidak adekuatnya respons terhadap perubahan klinis, berkurangnya perhatian dan konsentrasi, buruknya komunikasi serta tidak adekuatnya dalam pencatatan rekam medis, padahal dalam keadaan gawat darurat seorang anestesiologis harus dapat membuat keputusan cepat dan tepat kadang dengan informasi yang sangat terbatas. [5][6][7][8] Penelitian oleh Karanovic dkk. 9 pada anestesiologis di The Split University Hospital (Croatia) mendapatkan terjadi perubahan fungsi kognitif dan psikomotor pada anestesiologis yang bertugas di IGD setelah mereka melaksanakan tugas selama 24 jam.…”

Section: Pendahuluanunclassified

Perubahan fungsi kognitif dan psikomotor residen anestesiologi dan terapi intensif setelah 32 jam kerja

Syahrul

Dachlan

Marsaban

et al. 2017

MKA

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Anestesiologis yang bertugas di IGD dapat menjalani jam kerja 24 jam. Anestesiologis yang lelah mempunyai konsekuensi menurunnya fungsi kognitif dan psikomotor. Peserta PPDS Anestesiologi menjalani 32 jam kerja saat bertugas jaga IGD. Tujuan: Untuk mengetahui perubahan fungsi kognitif dan psikomotor PPDS Anestesiologi setelah menjalani 32 jam kerja. Metode: Penelitian ini mengobservasi 69 peserta PPDS Anestesiologi yang menjalani 32 jam kerja. Setiap peserta PPDS diperiksa fungsi kognitif dan psikomotor pada jam kerja ke-0 dan setelah 32 jam. Jumlah tidur ketika bertugas jaga dicatat. Fungsi kognitif diperiksa dengan MoCa-Ina dan psikomotor dengan grooved pegboard. Hasil: Secara statistik didapatkan penurunan bermakna fungsi kognitif (p=0,00) dan psikomotor pada tangan dominan/non-dominan (p=0,00/p=0,00), tetapi secara klinis fungsi kognitif dan psikomotornya masih dalam batas normal. Tidak terdapat pengaruh lamanya tidur dengan fungsi kognitif (p=0,121) dan psikomotor (p=0,282/p=0,317) setelah 32 jam kerja pada peserta PPDS Anestesiologi tidur minimal 5 jam dengan tidur kurang dari 5 jam. Kesimpulan: Fungsi kognitif dan Psikomotor peserta PPDS Anestesiologi setelah menjalani 32 jam kerja terbukti menurun, sedangkan lamanya tidur tidak terbukti mempengaruhi fungsi kognitif dan psikomotor.

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The fatigued anesthesiologist: A threat to patient safety?

Cited by 48 publications

References 50 publications

Monitoring Anesthesia Care Delivery and Perioperative Mortality in Kenya Utilizing a Provider-driven Novel Data Collection Tool

Monitoring Anesthesia Care Delivery and Perioperative Mortality in Kenya Utilizing a Provider-driven Novel Data Collection Tool

Mental workload and its association with fatigue in operating room personnel of Hamadan hospitals, Iran, 2016

Perubahan fungsi kognitif dan psikomotor residen anestesiologi dan terapi intensif setelah 32 jam kerja

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