Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach

• Autores: Mul Fedele, Malena Lis; López Gabeiras, María del Pilar; Simonelli, Guido; Diez, Joaquín José; Bellone, Giannina J.; Cagliani, Joaquín; Larrateguy, Luis; Eiguchi, Kumiko; Golombek, Diego A.; Cardinali, Daniel Pedro; Pérez Chada, Daniel; Vigo, Daniel Eduardo
• Año de publicación: 2023
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: BMC Public Health. 2023, 23, 2317
• Materia: SUEÑO; RITMO CIRCADIANO; MEDICOS; NEGLIGENCIA; FATIGA; ERRORES MÉDICOS
• Institución: Pontificia Universidad Católica Argentina

Fil: Mul Fedele, Malena Lis. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas. Instituto de Investigaciones Biomédicas. Laboratorio de Cronofisiología; Argentina
Fil: Mul Fedele, Malena Lis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: López Gabeiras, María del Pilar. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Simonelli, Guido. CIUSSS du Nord de L'Île-de-Montréal. Hospital del Sagrado Corazón de Montreal. Centro de Estudios Avanzados en Medicina del Sueño; Canadá
Fil: Simonelli, Guido. Universidad de Montreal. Facultad de Medicina. Departamento de Medicina; Canadá
Fil: Simonelli, Guido. Universidad de Montreal. Facultad de Medicina. Departamento de Neurociencia; Canadá
Fil: Diez, Joaquín José. Instituto Panamericano de Medicina del Sueño y Cronobiología; Argentina
Fil: Bellone, Giannina J. Pontificia Universidad Católica Argentina; Argentina
Fil: Bellone, Giannina J. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Cronobiología; Argentina
Fil: Cagliani, Joaquín. Hospital Universitario de North Shore. Departamento de Anestesiología; Estados Unidos
Fil: Larrateguy, Luis. Centro Privado de Medicina Respiratoria de Paraná; Argentina
Fil: Eiguchi, Kumiko. Universidad del Salvador; Argentina
Fil: Golombek, Diego A. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Cronobiología; Argentina
Fil: Golombek, Diego A. Universidad de San Andrés. Laboratorio del Tiempo Interdisciplinario; Argentina
Fil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina; Argentina
Fil: Pérez Chada, Daniel. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Vigo, Daniel Eduardo. Pontificia Universidad Católica Argentina. Facultad de Ciencias Médicas. Instituto de Investigaciones Biomédicas. Laboratorio de Cronofisiología; Argentina
Fil: Vigo, Daniel Eduardo. Katholieke Universiteit Leuven; Bélgica
Fil: Cardinali, Daniel Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Abstract: Background The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors. Methods This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed. Results Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00–1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16–3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10–2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1–4.3] vs 14.5% [95% CI, 5.9–23.0]; p = 0.01) in the actigraphic recording. Conclusions Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees’ sleep and wellbeing, increasing in turn their own and patients’ safety.