Quality of Emergency Care on the Night Shift

Silbergleit, Robert; Kronick, Steven L.; Philpott, Shelia; Lowell, Mark J.; Wagner, Christine

doi:10.1111/j.1553-2712.2006.tb01700.x

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…Overall, the number of accidents/near-accidents were fewer related to night shifts than with QRs, with the exception of incidents of involuntarily dozing off at work and while driving to/from work, where the associated risk was higher with night shifts. Increased risk of accidents/near-accidents with night shifts were expected based on previous studies (de Cordova et al 2016;Dorrian et al 2008;Silbergleit et al 2006;Sorita et al 2014;Zhang and Chan 2014) and the primary mechanisms for this are believed to be elevated levels of sleepiness and the physiological deactivation that occur around the circadian nadir of the workers biological night (Åkerstedt 1995). It should be noted that in-patients usually do not require the same level of care during nights compared to the rest of the day (Nicoletti et al 2014).…”

Section: Discussionmentioning

confidence: 89%

“…The researchers in that study made no direct attempts to delineate the role of inconvenient work hours in hospital deaths. However, other previous research has shown that patients who are admitted to hospitals at night or weekends have worse outcomes than those admitted at other times, where suboptimal levels of alertness and vigilance among the healthcare workers are at least part of the explanation (de Cordova et al 2016;Silbergleit et al 2006;Sorita et al 2014). These studies nevertheless allude more to the negative effects of night shift work, as night shifts have traditionally been researched more than QRs.…”

Section: Discussionmentioning

confidence: 96%

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Short rest between shifts (quick returns) and night work is associated with work-related accidents

Vedaa

Harris

Erevik

et al. 2019

Int Arch Occup Environ Health

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The aim of this study was to examine whether less than 11 hours between shifts (i.e. quick returns, QRs) and night shifts are associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses. Methods:The study was based on cross-sectional data from 1,784 nurses (response rate=60%; mean age=40.1 yrs., SD=8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different selfreported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors. Results:The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009;

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Short rest between shifts (quick returns) and night work is associated with work-related accidents

Vedaa

Harris

Erevik

et al. 2019

Int Arch Occup Environ Health

View full text Add to dashboard Cite

show abstract

“…[15] Yet, an independent study on emergency room physicians did not find any decline in functional outcomes for patients when nightshifts were compared to dayshifts, although a small increase in early mortality was detected. [16]…”

Section: Discussionmentioning

confidence: 99%

Mortality rates following trauma: The difference is night and day

Egol

Tolisano

Spratt³

et al. 2011

J Emerg Trauma Shock

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Background:Although most medical centers are equipped for 24-h care, some “middle of the night” services may not be as robust as they are during daylight hours. This would have potential impact upon certain outcome measurements in trauma patients. The purpose of this paper was to assess the effect of patient arrival time at hospital emergency departments on in-hospital survival following trauma.Materials and Methods:Data of patients, 18 years of age or older, with no evidence that they were transferred to or from that center were obtained from the National Trauma Data Bank Version 7.0. Patients meeting the above criteria were excluded if there was no valid mortality status, arrival time information, injury severity score, or trauma center designation. The primary analyses investigated the association of arrival time and trauma center level on mortality. Relative risks of mortality versus patient arrival time and trauma level were determined after controlling for age, gender, race, comorbidities, injury, region of the country, and year of admission.Results:In total, 601,388 or 71.7% of the 838,284 eligible patients were retained. The overall in-hospital mortality rate was 4.7%. The 6 p.m. to 6 a.m. time period had a significantly higher adjusted relative risk for in-hospital mortality than the 6 a.m. to 6 p.m. time frame (ARR=1.18, P<;0.0001). This pattern held across trauma center levels, but was the weakest at Level I and the strongest at Level III/IV centers (Level I: ARR=1.10, Level II: ARR=1.14, and combined Level III/IV: ARR=1.32, all P<0.0001).Conclusion:Hospital arrival between midnight and 6 a.m. was associated with a higher mortality rate than other times of the day. This relationship held true across all trauma center levels. This information may warrant a redistribution of hospital resources across all time periods of the day.

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“…Tiredness of physicians after a night shift has been reported and may be a causal factor for this worsened prognosis. However, whether physical fatigue is associated with poorer outcomes still remains controversial as some studies did not find clinical differences in care or in mortality between night and day [7].…”

Section: Introductionmentioning

confidence: 96%

Weaker compressions after night shift? The WeCAN manikin study

Philippon

Nguyen²,

Raynal

et al. 2016

European Journal of Emergency Medicine

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To assess whether the quality of chest compressions (CC) differs before and after a night shift. We carried out a cluster randomized study in three Emergency Departments and three ICUs in Paris, France. Physicians were assessed on a control day and immediately following after a night shift. The primary endpoint was the proportion of CC with a depth greater than 50 mm. We analyzed 67 participants. The proportion of CC with a depth greater than 50 mm was similar on a control day and after a night shift [52% in both groups, mean difference of 0 (95% confidence interval: -17 to 17)]. Other indicators of CC quality were unchanged after a night shift, except for the mean depth of CC (51 vs. 48 mm, P=0.01). We report in our sample that the quality of CC after a night shift is not inferior to a control day.

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Quality of Emergency Care on the Night Shift

Cited by 8 publications

References 15 publications

Short rest between shifts (quick returns) and night work is associated with work-related accidents

Short rest between shifts (quick returns) and night work is associated with work-related accidents

Mortality rates following trauma: The difference is night and day

Weaker compressions after night shift? The WeCAN manikin study

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