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Sun 1 Apr 2007 01:48 PM

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Cutting work hours won’t fix junior doctor fatigue

Cutting junior doctors' working hours and giving them more rest breaks won't alone reduce fatigue or the risk of error, British researchers have concluded.

Cutting junior doctors' working hours and giving them more rest breaks won't alone reduce fatigue or the risk of error, British researchers have concluded.

An anonymous questionnaire on work patterns, sleepiness and errors related to tiredness was sent to more than 2,000 junior doctors.

1400 doctors, working 40 or more hours a week in accordance with schedules designed to cut weekly working hours and reduce the associated risk of errors, responded.

Almost a third (30%) were classified as "excessively sleepy" according to a recognised sleepiness scale.

One in four said that since becoming a doctor they had fallen asleep at the wheel of their car while driving home. The doctors were twice as likely as the general population to score as excessively sleepy, and more than twice as likely to report nearly falling asleep at the wheel as British male drivers.

Night shifts and unscheduled changes to rosters were more consistently linked to sleepiness and errors than the total number of hours worked.

Conversely, regular access to supervision reduced the likelihood of sleepiness and errors, irrespective of the total hours worked.

"We conclude that long work hours are not the only aspect of work patterns that needs to be managed to reduce sleepiness and fatigue related clinical errors among junior doctors," say the authors. "The findings support the view that a more comprehensive risk management approach is needed to reduce sleepiness and improve care."

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