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Residents doctors\' shifts too long, report finds

 Physicians in training work "dangerously long hours" that should be reduced, a U.S. report says.
New rules for residency training set to take effect in the U.S. on July 1 fall "considerably short" of what is needed to ensure patient safety, say the authors of a report in Friday's issue of the journal Nature & Science of Sleep.
 
"Few people enter a hospital expecting that their care and safety are in the hands of someone who has been working a double-shift or more with no sleep," said Dr. Lucian Leape, a professor of health policy at the Harvard School of Public Health and a co-author of the report."If they knew, and had a choice, the overwhelming majority would demand another doctor or leave," he added in a statement.
 
The report looked at residents' work hours, supervision, and safety. It is the product of a conference held last June at Harvard Medical School.
 
Under the new rules, first-year residents will work shifts no longer than 16 straight hours. But more experienced residents could clock up to 28 hours at a stretch.
 
The report's authors calls for all residents' shifts to be limited to a maximum of 16 hours.
Some of the other recommendations:
  • Require attending physicians to supervise all hospital admissions.
  • Identify in real time when a resident physician's workload is excessive and add more staff.
  • Assign other hospital personnel to fill out paperwork, start intravenous lines and draw blood to allow residents to instead maximize their time on tasks of more educational value.
  • Provide transportation to all residents who report feeling too tired to drive home safely.
  • Make fatigue management a national patient safety goal that applies not only to residents but also to nurses, attending physicians and other health care workers.
Changing training to eliminate long shifts, waits and inefficiency could produce savings to offset extra hiring if needed, the authors suggested.
 

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