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Medical residents in hospitals are often required to be on duty for
long hours. In 2003 the organization overseeing graduate medical
education adopted common program requirements to restrict resident
workweeks, including limits to an average of 80 hours over 4 weeks
and the longest consecutive period of work to 30 hours in order to
protect patients and residents from unsafe conditions resulting
from excessive fatigue. Resident Duty Hours provides a timely
examination of how those requirements were implemented and their
impact on safety, education, and the training institutions. An
in-depth review of the evidence on sleep and human performance
indicated a need to increase opportunities for sleep during
residency training to prevent acute and chronic sleep deprivation
and minimize the risk of fatigue-related errors. In addition to
recommending opportunities for on-duty sleep during long duty
periods and breaks for sleep of appropriate lengths between work
periods, the committee also recommends enhancements of supervision,
appropriate workload, and changes in the work environment to
improve conditions for safety and learning. All residents, medical
educators, those involved with academic training institutions,
specialty societies, professional groups, and consumer/patient
safety organizations will find this book useful to advocate for an
improved culture of safety. Table of Contents Front Matter Abstract
Summary 1 Background and Overview 2 Current Duty Hours and
Monitoring Adherence 3 Adapting the Resident Educational and Work
Environment to Duty Hour Limits 4 Improving the Resident Learning
Environment 5 Impact of Duty Hours on Resident Well-Being 6
Contributors to Error in the Training Environment 7 Strategies to
Reduce Fatigue Risk in Resident Work Schedules 8 System Strategies
to Improve Patient Safety and Error Prevention 9 Resources to
Implement Improvements for Patient Safety and Resident Training
Appendix A Statement of Task Appendix B Comparison of Select
Scheduling Possibilities Under Committee Recommendations and Under
2003 ACGME Duty Hour Rules Appendix C International Experiences
Limiting Resident Duty Hours Appendix D Glossary, Acronyms, and
Abbreviations Appendix E Committee Member Biographies Appendix F
Public Meeting Agendas Index
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