Clinical Activity During Night-shift: an Ecological Study
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|ClinicalTrials.gov Identifier: NCT04123015|
Recruitment Status : Recruiting
First Posted : October 10, 2019
Last Update Posted : October 10, 2019
|Condition or disease|
|Nightshift Work Handoff Sessions Stress, Psychological Regret Sleep|
Various medical problems of patients admitted to an internal medicine ward can worsen during the stay. Furthermore, new, unidentified problems can develop (complications, medication errors, delirium, acute anxiety or pain, etc). During evenings, nights and week-ends, emergent needs of hospitalized patients are usually cared for by physicians in-training, who are in charge of a large number of patients. Hence, physicians should have a wide range of medical knowledge and procedural skills and know how acute problems are dealt with in the unique environment of the healthcare institution. Training physicians should also be able to obtain information and counseling efficiently, either from clinical guidelines, senior supervisors, or specialists.
These requirements may represent a significant stress for training physicians and may have a major impact on their health, quality of life, and finally on the quality of inpatient care. Nightshift work may lead later to a high burden of regrets among caregivers.
Better knowledge of training needs, organization features, coping strategies, and regrets associated with nightshift duty are important to prepare training physicians to that demanding and necessary task. Understanding of the epidemiology of night-shift ward emergencies could provide guidance concerning the required level of staffing and training of the responding medical team.
Furthermore, efficient transmission of information between day and night staff (so-called handoffs) is a difficult yet important part of care. Systematic observation of handoff sessions between physicians before and after nightshifts may enhance previous knowledge on key components of these topics.
The investigators will evaluate the incidence causes, and prognosis of night-shift emergencies in internal medicine wards by direct observation of the nightshift work of a convenient sample of internal medicine residents. By the means of before-and-after shift completion of various validated questionnaires, the investigators will explore quantitatively and qualitatively the physiological and psychological impact on nightshift work for physicians in training.
The planned study will also provide qualitative and quantitative data concerning handoffs session, and the repercussions on night shift emergencies management.
|Study Type :||Observational|
|Estimated Enrollment :||25 participants|
|Observational Model:||Ecologic or Community|
|Official Title:||Clinical Activity During Night-shift: an Ecological Study|
|Actual Study Start Date :||October 3, 2019|
|Estimated Primary Completion Date :||April 2020|
|Estimated Study Completion Date :||October 2020|
- Incidence of nightshift interventions [ Time Frame: 12 hours ]
- % of patients with nightshift interventions of different intensity [ Time Frame: 12 hours ]Rated on an ad-hoc scale (from "phone intervention only" to "active resuscitation")
- % of patients with different causes of nightshift interventions [ Time Frame: 12 hours ]Rated on an ad-hoc scale listing the different causes (e.g. acute confusion; chest pain, etc)
- Incidence of selected outcomes of nightshift intervention [ Time Frame: 24 hours ]Rated on an ad-hoc scale (from "death" to "problem resolves without further intervention"
- Incidence of specific interventions during nightshift [ Time Frame: 12 hours ]Rated on an ad-hoc list, from "Provision of CPR or intubation" to "Prescription of any new drug"
- Incidence of predictable nightshift emergencies [ Time Frame: 12 hours ]Rated on an ad-hoc scale, from "Unexpected" to "Expected"
- Incidence of preventable nightshift emergencies [ Time Frame: 12 hours ]Rated on an ad-hoc scale, from "Unpreventable" to "Very likely preventable"
- incidence of sleep problems in nightshift residents [ Time Frame: 30 days ]
- severity of sleep problems in nightshift residents [ Time Frame: 30 days ]measured with the insomnia severity index questionnaire, ISI
- incidence of stress symptoms in nightshift residents [ Time Frame: 30 days ]
- severity of stress symptoms in nightshift residents [ Time Frame: 30 days ]Measured with an ad hoc scale (From "no stress at all" to "intense stress most of the time")
- incidence of regrets in nightshift residents [ Time Frame: 30 days ]
- severity of regrets in nightshift residents [ Time Frame: 30 days ]Measured with the regret intensity questionnaire(RIS-10)
- incidence of burnout symptoms in nightshift residents [ Time Frame: 30 days ]
- severity of burnout symptoms in nightshift residents [ Time Frame: 30 days ]Measured with the Copenhagen Burnout Inventory, CBI
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04123015
|Contact: Pauline DARBELLAY FARHOUMAND, MD||+41223729050||Pauline.Darbellay@hcuge.ch|
|Contact: Nicolas Garin, MD||+41223729050||Nicolas.Garin@hcuge.ch|
|Geneva University Hospitals||Recruiting|
|Geneva, Switzerland, 1205|
|Contact: Pauline DARBELLAY FARHOUMAND, MD +4122372950 Pauline.Darbellay@hcuge.ch|
|Principal Investigator:||Pauline DARBELLAY FARHOUMAND, MD||Geneva University Hospitals, General Internal Medicine Department|