Assessment of fitness to perform using a validated self-test in obstetric and gynecological night shifts in the Netherlands

The field of obstetrics and gynecology requires complex decision-making and skills because of unexpected high-risk situations. These skills are influenced by alertness, reaction time, and concentration. Night shifts result in sleep deprivation, which might impair these functions, although it is stil...

Full description

Saved in:
Bibliographic Details
Published in:American journal of obstetrics and gynecology 2021-06, Vol.224 (6), p.617.e1-617.e14
Main Authors: Tummers, Fokkedien H.M.P., Huizinga, Coen R.H., van Pampus, Mariëlle G., Stockmann, Hein B.A.C., Cohen, Adam F., van der Bogt, Koen E.A., Moll, E., van Oort, C.J., Jansen, Frank Willem, Hellebrekers, Bart W.J.
Format: Article
Language:English
Subjects:
fatigue
obstetrics and gynecology
patient safety
performance measures
quality improvement
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The field of obstetrics and gynecology requires complex decision-making and skills because of unexpected high-risk situations. These skills are influenced by alertness, reaction time, and concentration. Night shifts result in sleep deprivation, which might impair these functions, although it is still unclear to what extent. This study aimed to investigate whether a night shift routinely impairs the obstetrics and gynecology consultants’ and residents’ fitness to perform and whether this reaches a critical limit compared with relevant frames of reference. Residents (n=33) and consultants (n=46) in obstetrics and gynecology conducted multiple measurements (n=415) at precall, postcall, and noncall moments with the fitness to perform self-test. The self-test consists of an adaptive pursuit tracking task that is able to objectively measure alertness, reaction time, concentration, and hand-eye coordination and Visual Analog Scale tests to subjectively score alertness. The test is validated with a sociolegal reference of a 0.06% ethanol blood concentration (the peak level after 2 units of alcohol, the legal driving limit). This equals −1.37% on the objective score and −8.17 points on subjective alertness. Linear mixed models were used to analyze the difference within subjects over a night shift, integrating repeated measures over time. The overnight objective difference between postcall and precall measurements was −0.62 (P
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2021.01.019