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• W2001898049 abstract "Despite efforts by the Accreditation Council for Graduate Medical Education, extended work shifts lasting up to 30 consecutive hours still are permitted. Shorter shifts are demonstrably associated with closer attention to patients and fewer medication errors. An alternative to shortening shifts is to provide for taking naps—a proved means of relieving fatigue in the transportation and manufacturing industries. In a 12-month crossover trial conducted at an academic teaching hospital, the investigators examined the effects of a call-night nap on the total amount of sleep and on fatigue. For the first or last 2 weeks of every month, on-call interns were allowed to take a nap while on duty. A resident physician on night-float service covered for napping interns between midnight and 7:00 am. Sleep was measured using wristwatch actigraphy. Random alerts reminded the interns to rate fatigue on the Stanford Sleepiness scale. Use of coverage was assessed from hospital paging logs and structured interviews. Thirty-eight of 40 interns rotating on the general medicine service participated for at least 1 month for a total of 119 of 178 intern-months (67%). Interns on the nap schedule slept an average of 41 minutes more than those on the standard schedule, a difference significant at the 0.001 level. Sleep efficiency improved on the nap schedule (80% vs 73%). Interns reported less fatigue while on the nap schedule, especially on the postcall day. Interns received, on average, 42 minutes of sleep for each hour of coverage. This translated into 3.9 hours of actual sleep during 5.7 hours of coverage; the covered time not spent sleeping was used to finish work. Interviews made it clear that most interns experienced improved sleep, less fatigue, and an improved ability to focus on patient care. During the time available for napping, the interns tended to forward the care of the patients they were assigned to cover (crossover patients), but not their own patients; all but one of 26 interns interviewed expressed a wish that their patients not be cared for on the nap schedule during periods of coverage so that they could better maintain communication with them. These findings suggest that interns who are allowed a call-night nap during an extended shift do obtain more sleep and experience less fatigue. Interns taking part in this study were concerned about maintaining continuous care for their patients, and future studies of this type should address this concern." @default.
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• W2001898049 date "2006-11-01" @default.
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• W2001898049 title "The Effects of On-Duty Napping on Intern Sleep Time and Fatigue" @default.
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• W2001898049 doi "https://doi.org/10.1097/01.ogx.0000243900.55721.0d" @default.
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