Influence of Residents' Workload, Mental State and Job Satisfaction on Procedural Error : a prospective daily questionnaire-based study

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概要

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• BACKGROUND : Previous studies have suggested positive association between residents workload and medical errors. However, few studies have investigated the possible associations between procedural errors, workload, and the individual characteristics of residents, including personality, mental state and job satisfaction.OBJECTIVE : To explore possible associations of workload and individual characteristics of residents with their procedural error rates.DESIGN : Prospective observational study based on a daily questionnaire.PARTICIPANTS : Residents of postgraduate year 1 and 2.MEASUREMENTS : Residents workload (on-calls, work hours, sleep and napping hours), residents physical and mental health state, personality inventory, and procedural error rate (defined as procedural error counts divided by overall procedural attempts).RESULTS : On average, the residents (N=49) were responsible for 9.8 inpatients per day (range, 1.9-23.1), worked for 16.0 hours per day (range, 12.6-19.8), slept for 4.4 hours per day (range, 2.8-5.7), napped for 0.2 hours per day (range, 0-0.7), and experienced 1 overnight work shift every 7.2 days. The procedural error rate was 2.2 per 10 procedures (range, 0.4-5.0). Using a multivariable adjusted regression model, significant factors associated with lower error rates included : longer napping ; reflective personality ; better mental state ; higher job satisfaction ; and, less on-call frequency.CONCLUSIONS : Procedural error of residents is positively associated with higher on-call frequency and inversely associated with napping, reflective personality, better mental state, and higher job satisfaction. For reducing procedural error among residents, improvement of modifiable factors, such as workload and mental health, is needed.

• 日本総合診療医学会の論文
• 2008-10-01

著者

• Fukui Tsuguya

  聖路加国際病院 一般内科

• Fukui T

  St. Luke's International Hospital

• Ohde Sachiko

  St. Luke's Life Science Institute

• TOKUDA Yasuharu

  University of Tsukuba Graduate School of Human Sciences

• MINE Tetsuya

  Tokai University School of Medicine

• OHDE Sachiko

  Center for Clinical Epidemiology, St. Luke's Life Science Institute, St. Luke's International Hospit

• Tokuda Yasuharu

  Center For Clinical Epidemiology St. Luke's Life Science Institute

• Fukui Tsuguya

  Department Of Clinical Epidemiology Kyoto University Graduate School Of Medicine

• HORINOUCHI Hidehito

  Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital

• Tokuda Yasuharu

  Mito Kyodo Hospital University Of Tsukuba

• Fukui Tsuguya

  Center For Clinical Epidemiology St. Luke's Life Science Institute St. Luke's Internationa

• Takahashi Osamu

  Center For Clinical Epidemiology St. Luke's Life Science Institute St. Luke's Internationa

• Horinouchi Hidehito

  Division Of Internal Medicine And Thoracic Oncology National Cancer Center Hospital

• Fukui Tsuguya

  Department Of General Medicine And Clinical Epidemiology Kyoto University Graduate School Of Medicin

• Nishimura Naoki

  Department Of Applied Biological Chemistry The University Of Tokyo

• Ishikawa Ryoichi

  Department Of Patient Safety And Risk Management St. Luke's International Hospital

• Nishimura Naoki

  Department Of Medicine St. Luke's International Hospital

• HORINOUCHI Hidehito

  Department of Medicine, St. Luke's International Hospital

• TERAI Mineko

  Department of Patient Safety and Risk Management, St. Luke's International Hospital

• Terai Mineko

  Department Of Epidemiology And Health Care Research Graduate School Of Medicine And Public Health Ky

• Tokuda Yasuharu

  Department Of Internal Medicine Mito Kyodo Hospital University Of Tsukuba

• Ohde Sachiko

  Center for Clinical Epidemiology, St. Luke's Life Science Institute

• OHDE Sachiko

  Center for Clinical Epidemiology, St. Luke's International Hospital

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