Study finds higher rates of medication errors in surgical patients in the era after ACGME duty hours reform.J Surg Educ. 2015 Jun 15; [Epub ahead of print].
National incidence of medication error in surgical patients before and after Accreditation Council for Graduate Medical Education duty-hour reform.
Vadera S, Griffith SD, Rosenbaum BP, et al. J Surg Educ. 2015 Jun 15; [Epub ahead of print].This pre-post study examines the effects of the 2003 ACGME duty hours reform on medication errors among hospitalized surgical patients. The authors hypothesized that the increase in handoffs and a changing attitude toward work—also referred to as a shift-work mentality—might lead to an increase in medication errors. Using the Nationwide Inpatient Sample, a representative sample of hospitalizations maintained by AHRQ'sHealthcare Cost and Utilization Project, investigators compared medication error rates for surgical patients between 2000–2003 versus 2003–2011, accounting for trends over time and patient and hospital level covariates. Error rates for teaching hospitals were higher than expected based on patient and hospital characteristics, leading the researchers to conclude that duty hour reform increased medication errors. The magnitude of the effect was modest, and only reached statistical significance for 2 of the 8 years they examined. The effects of duty hours on safety remain controversial, without a clear consensus.
Medmarx Data Report: A Chartbook of Medication Error Findings from the Perioperative Settings from 1998-2005.
Rockville, MD: United States Pharmacopeia; 2007.
National Surgical Quality Improvement Program.
American College of Surgeons.
Restricted duty hours for surgeons and impact on residents quality of life, education, and patient care: a literature review.
Pape H, Pfeifer R. Patient Saf Surg. 2009;3:3.
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