Despite changes to policies governing resident work schedules--notably new rules that cut shifts back to 24 to 30 hours--a new study suggests that residents still aren't getting more sleep, are still making mistakes, and are still getting into car accidents that result from sleep deprivation. The study, which appears in Pediatrics this week, found that 2003 changes in the Accreditation Council for Graduate Medical Education's standards for residents have had surprisingly little effect.
The study of 220 residents shows that 56 percent of residents worked 30 or more hours at a stretch after 2003. The length of such extended work shifts decreased only 3 percent, to 28.5 hours. Residents got the same amount of sleep (7.5 hours a day) after the rules were enacted as before. Meanwhile, residents made about the same number of mistakes (1.5 mistakes per 100 orders) before and after the policy change, and had the same number of accidental needle-sticks and car crashes.
Researchers behind the study note that it only included pediatric residents at three large children's hospitals in Boston, Washington, D.C. and Palo Alto, CA, which may limit how broadly it can be applied. However, they don't seem to be the only ones who see a problem here. For example, Brigham and Women's Hospital in Boston has cut surgical shifts for residents from 24 hours straight to 12 hours.
To learn more about the study:
- read this USA Today piece
Study: Long hospital shifts boost mistakes
Study: Residents work too many hours
Studies: Resident shift limits don't lower mortality
Cutting resident hours could cost big bucks