Multi-center Clinical Trial of Limiting Resident Work Hours on ICU Patient Safety
NCT02134847 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 413
Last updated 2019-04-30
Summary
In this proposal, we seek to address conclusively two knowledge gaps: 1) the lack of data on the relationship between PGY2+ (post graduate year 2) sleep deprivation and patient safety; and 2) the lack of data on the relationship between resident sleep deprivation and preventable patient injuries. Through the Clinical and Translational Science Award (CTSA)-funded Sleep Research Network, the largest and only federally-funded sleep science network in the U.S., we propose conducting a multi-center randomized crossover trial in six pediatric ICUs staffed by PGY2 and PGY3 residents. We will compare rates of all serious errors (i.e., rates of harmful and other serious medical errors due to any cause, including but not limited to fatigue-related errors, handoff errors, and provider knowledge deficits) of a sleep and circadian science-based (SCS) intervention schedule with a traditional schedule that includes frequent shifts of 24 hours or longer. Our specific aims will be:
1. To test the hypothesis that PGY2\&3 residents working on an SCS intervention schedule will make significantly fewer harmful medical errors (preventable adverse events) and other serious medical errors (near misses) while caring for ICU patients than residents working on a traditional schedule; (primary endpoints: resident-related preventable adverse events and near misses)
2. To test the hypothesis that rates of harmful medical errors (preventable adverse events) and other serious medical errors (near misses) throughout the ICU (i.e., those involving and those not involving residents) will be lower in ICUs when PGY2\&3 residents work on an SCS intervention schedule than when residents work on a traditional schedule; (major secondary endpoints: ICU-wide preventable adverse events and near misses)
3. To test the hypothesis that resident physicians' risk of neurobehavioral performance failures and motor vehicle crashes - as assessed through simple visual reaction time tasks \[Johns Drowsiness Score (JDS) and Psychomotor Vigilance Task (PVT) lapses\] - will be lower on the SCS intervention schedule than on the traditional schedule. (major secondary endpoints: resident neurobehavioral performance and predicted driving safety)
Conditions
- Physician Fatigue
Interventions
- OTHER
-
SCS intervention schedule
Sponsors & Collaborators
-
Brigham and Women's Hospital
lead OTHER
Principal Investigators
-
Christopher Landrigan, MD, MPH · Brigham and Women's Hospital
-
Charles A Czeisler, MD, PhD · Brigham and Women's Hospital
Study Design
- Allocation
- RANDOMIZED
- Purpose
- HEALTH_SERVICES_RESEARCH
- Masking
- SINGLE
- Model
- CROSSOVER
Eligibility
- Min Age
- 21 Years
- Sex
- ALL
- Healthy Volunteers
- Yes
Timeline & Regulatory
- Start
- 2013-07-01
- Primary Completion
- 2017-03-05
- Completion
- 2017-03-05
Countries
- United States
Study Locations
More Related Trials
-
Creating Naptime: An Overnight, Non-Pharmacologic Intensive Care Unit Sleep Promotion Protocol
NCT03119207 ·Status: COMPLETED ·Phase: NA
-
Fatigue in Short-Haul Operations
NCT05524441 ·Status: RECRUITING
-
The Impact of Night Float on Anesthesiology Resident Sleep Patterns
NCT03325244 ·Status: COMPLETED
-
Sleep/Wake Protocol Implementation to Improve Sleep Quality in the ICU
NCT03313115 ·Status: COMPLETED
-
Effect and Utilization of Protected Time Among Interns on Extended Duty-Hour Call Shifts
NCT00983008 ·Status: TERMINATED ·Phase: NA
-
Optimizing Sleep/Wake Related Cognitive Efficacy
NCT02412410 ·Status: COMPLETED ·Phase: NA
-
Effect of Night Float Call on Sleep and Activity Patterns Among Anesthesia Residents
NCT05043038 ·Status: COMPLETED
-
Prevalence and Affecting Factors of Sleep and Circadian Rhythm Disorders in ICU
NCT06346613 ·Status: RECRUITING
-
Pathophysiology of Circadian Rhythm Delayed Sleep Wake Phase Disorder
NCT06471374 ·Status: RECRUITING ·Phase: NA
-
Impact of a Multifaceted Intervention of Environment Control in the ICU to Optimize Quantity and Quality of Sleep
NCT05694052 ·Status: COMPLETED ·Phase: NA
-
Quantifying and Developing Countermeasures for the Effect of Fatigue-Related Stressors on Automation Use and Trust During Robotic Supervisory Control
NCT02755493 ·Status: COMPLETED ·Phase: NA
-
Reducing the Risk of Alarm Fatigue Through the Use of Focused Management in Safety Huddles
NCT02319421 ·Status: COMPLETED ·Phase: NA
-
Phenotypic and Genotypic Markers of Performance Vulnerability to Sleep Loss
NCT02130791 ·Status: COMPLETED ·Phase: NA
-
The Effects of Bright Light Exposure on ICU Nurses
NCT03331822 ·Status: COMPLETED ·Phase: NA
-
Comparison Across Multiple Types of Sleep Deprivation
NCT04211506 ·Status: COMPLETED ·Phase: NA
-
Call- Associated Acute Fatigue in Surgical Residency
NCT01284842 ·Status: COMPLETED
-
Impact of a Day Without Clinical Activity Before Night Shift on Non-technical Skills of Intensive Care Residents
NCT05146856 ·Status: UNKNOWN
-
Improving Night Shift Nurses' Health and Reducing Burnout
NCT06829979 ·Status: COMPLETED ·Phase: NA
-
Sleep and Circadian Treatments for Shift Workers
NCT03813654 ·Status: TERMINATED ·Phase: NA
-
Repeated Challenge of Insufficient Sleep: Endothelial Effects
NCT01523535 ·Status: COMPLETED ·Phase: NA
-
Circadian Rhythm Disruption in the Hospital Intensive Care Environment
NCT05828680 ·Status: ACTIVE_NOT_RECRUITING
-
Biomarkers of Increased Free Living Sleep Time
NCT04214184 ·Status: COMPLETED ·Phase: NA
-
Comprehensive Police Fatigue Management Program
NCT00246051 ·Status: COMPLETED ·Phase: NA
-
Sleep Investigation in Respirator Treated ICU Patients: the Importance of Intensive Environment
NCT01681043 ·Status: COMPLETED ·Phase: NA
-
Improving Sleep Quality in Flap Patients in the SICU
NCT03957317 ·Status: COMPLETED ·Phase: NA