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Objective Assessment of Fitness to Perform (FTOP) After Surgical Night Shifts in the Netherlands: An Observational Study Using the Validated FTOP Self-test in Daily Surgical Practice.
- Source :
-
Annals of surgery [Ann Surg] 2019 Nov; Vol. 270 (5), pp. 930-936. - Publication Year :
- 2019
-
Abstract
- Background: Surgical skills and decision making are influenced by alertness, reaction time, eye-hand coordination, and concentration. Night shift might impair these functions but it is unclear to what extent. The aim of this study was to investigate whether a night shift routinely impairs the surgeon's fitness to perform and whether this reaches a critical limit as compared to relevant frames of reference.<br />Methods: Consultants (n = 59) and residents (n = 103) conducted fitness to perform measurements at precall, postcall, and noncall moments. This validated self-test consists of an adaptive tracker that is able to objectively measure alertness, reaction time, concentration, and eye-hand coordination, and multiple visual analog scales to subjectively score alertness. Results are compared to sociolegal (ethanol) and professional (operative skills) frames of reference that refer to a decrease under the influence of 0.06% ethanol.<br />Results: Residents spent 1.7 call hours asleep on average as compared to 5.4 for consultants. Subjective alertness decreased in residents after night shifts (-13, P < 0.001) but not in consultants (-1.2, P = NS). The overnight difference in tracker score was -1.17 (P < 0.001) for residents and 0.46 (P = NS) for surgeons. Postcall subjective alertness only correlated to objective alertness in consultants. For residents, hours slept on-call correlated to objective alertness. For consultants, subsequent night calls significantly correlated to objective alertness, with the third subsequent call related to performance below the reference.<br />Conclusions: Consultants remain fit to perform after night call, but subsequent calls may compromise clinical activities. This study provides insight and awareness of individual performance with clear frames of reference.
- Subjects :
- Attention physiology
Cohort Studies
Consultants
Fatigue epidemiology
Female
General Surgery education
Humans
Internship and Residency
Male
Netherlands
Prospective Studies
Reproducibility of Results
Surgeons
Task Performance and Analysis
After-Hours Care methods
Clinical Competence
Fatigue physiopathology
Physical Fitness physiology
Self-Assessment
Work Schedule Tolerance
Subjects
Details
- Language :
- English
- ISSN :
- 1528-1140
- Volume :
- 270
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Annals of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31567505
- Full Text :
- https://doi.org/10.1097/SLA.0000000000003517