Rates of medication errors among depressed and burnt out residents: prospective cohort study

Abstract

Objective To determine the prevalence of depression and burnout among residents in paediatrics and to establish if a relation exists between these disorders and medication errors. Design Prospective cohort study. Setting Three urban freestanding children's hospitals in the United States. Participants 123 residents in three paediatric residency programmes. Main outcome measures Prevalence of depression using the Harvard national depression screening day scale, burnout using the Maslach burnout inventory, and rate of medication errors per resident month. Results 24 (20%) of the participating residents met the criteria for depression and 92 (74%) met the criteria for burnout. Active surveillance yielded 45 errors made by participants. Depressed residents made 6.2 times as many medication errors per resident month as residents who were not depressed: 1.55 (95% confidence interval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001). Burnt out residents and non-burnt out residents made similar rates of errors per resident month: 0.45 (0.20 to 0.98) compared with 0.53 (0.21 to 1.33, P=0.2). Conclusions Depression and burnout are major problems among residents in paediatrics. Depressed residents made significantly more medical errors than their nondepressed peers; however, burnout did not seem to correlate with an increased rate of medical errors.

A study of otolaryngology resident quality of life and sleepiness

“…Higher stress levels are more likely to be encountered during the head and neck oncology and junior years of residency. Identifying contributing factors, including lack of control, work planning/organization,3 lack of sleep, stress, and depression during training can potentially minimize further mental distress and medical error 1. By identifying otolaryngology residents at risk, program directors and the residents themselves may intervene earlier when patient care or resident well‐being is at risk.…”

“…Daily situations, including stressful oncologic encounters and lack of sleep, contribute to the burden 4. These stressors are exacerbated by sleepiness and lack of leisure time 1. Resident fatigue, sleepiness, and distress are associated with self‐perceived medical errors4, 7, 8 and self‐reported medication errors 1.…”

“…These stressors are exacerbated by sleepiness and lack of leisure time 1. Resident fatigue, sleepiness, and distress are associated with self‐perceived medical errors4, 7, 8 and self‐reported medication errors 1. The Institute of Medicine estimated that medical errors cause 44,000 to 98,000 patient deaths per year 9.…”

“…The Institute of Medicine estimated that medical errors cause 44,000 to 98,000 patient deaths per year 9. Depressed residents have a sixfold higher medication error rate than non‐depressed peers and nearly half of these physicians are not cognizant of their depressed status 1. Burnout, depression, and quality of life (QOL) have not been shown as predictors of standardized testing results 10…”

Burned Out at the Bedside: Patient Perceptions of Physician Burnout in an Internal Medicine Resident Continuity Clinic

“…1 It is measured using a validated instrument, 1 and reported by 50-75 % of resident physicians. [2][3][4] Burnedout residents self-report increased rates of medical errors, 4,5 suboptimal patient care, 2 and reduced empathy. 6,7 A few studies have tried to substantiate these findings with independent observational data but have not provided confirmatory evidence.…”