EMS Fatigue Linked to Medical Errors and Medical Malpractice
EMS personnel working 24-hour shifts present both a workplace issue and a patient safety issue -- including increased stress on the job, less patient comfort, higher error rates and "near misses" with case related procedures.
January 20, 2012 /24-7PressRelease/ -- Too many round-the-clock shifts worked by emergency medical service providers is linked to an increase in medical errors that can harm and may possibly even kill patients. The evidence presented in a recent study reveals that the medical field is doing a disservice to EMS providers as well as patients when already exhausted EMS workers are required to pull multiple marathon shifts. This is because the human brain cannot function reliably after 24 consecutive hours with no sleep.
EMS workers evaluated in the study included paramedics and other first responders. They are healthcare professionals who work in emergency medical situations, providing advanced levels of care for patients and accident victims.
It is well known that the skill and timeliness of the services provided by EMS enhances a patient's chances of survival and potentially limits any lasting injury. On the other hand, when EMS providers are mentally or physically fatigued, the risk of medical error or harm to the patient is greatly magnified.
EMS Workers and Fatigue Study
A study published by Prehostpital Emergency Care was based on a questionnaire measuring fatigue and adjusted for the EMS environment was utilized to assess physical and mental fatigue. The researchers also developed a new 44-item survey tool to elicit self-reported safety outcomes data, including provider injury, medical errors or adverse events and safety-compromising behaviors, such as excessive speeding. The study found:
- More than half of the EMS respondents would be classified as fatigued
- 18 percent reported an injury
- 41 percent reported a medical error or adverse event
- A staggering 90 percent reported a safety-compromising behavior
Emergency medical technicians and paramedics work long and demanding hours in a highly unpredictable occupation. This instability undoubtedly adds to the stress and fatigue levels of these first responders. In addition, because of the very nature of the EMS position, responders are often confronted with medical emergencies where they do not have the luxury of a complete picture of the patient's risk factors.
Therefore, because of this variable, it is paramount that EMS responders are well rested and alert. If not, according to the study, a patient is at a significantly higher risk of becoming the victim of an unnecessary -- and potentially avoidable -- medical error.
24-Hour Society Demands Shift Workers
Over the past several decades, productivity demands in the U.S. have increased the number of people who work outside of the traditional "9 to 5" shift. But this has also led to an increase in such public health issues as excessive fatigue and sleep disturbance among shift workers.
Most EMS workers reported working between six and 15 shifts per month. At least half of the workers reported a standard shift that was 24 hours long -- and patients and accident victims being cared for by exhausted EMS workers face grave risks. If this practice is allowed to continue unchecked, it could easily result in one or more of the following:
- Increase in medication errors
- Decrease in safe patient care
- Increase in mortality and morbidity
- Increase in legal liability risk, including medical malpractice
EMS personnel working 24-hour shifts present both a workplace issue and a patient safety issue -- including increased stress on the job, less patient comfort, higher error rates and "near misses" with case related procedures. Exposing EMS workers to excessively long shifts can trigger unsafe practices, the impact of which can resonate throughout the particular patient's care and overall health, as well as potentially exposing the EMS provider and other related medical institutions to medical malpractice liability.
Article provided by Silvers, Langsam & Weitzman, P.C.
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