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首页> 外文期刊>Prehospital emergency care >Shorter Versus Longer Shift Durations to Mitigate Fatigue and Fatigue-Related Risks in Emergency Medical Services Personnel and Related Shift Workers: A Systematic Review
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Shorter Versus Longer Shift Durations to Mitigate Fatigue and Fatigue-Related Risks in Emergency Medical Services Personnel and Related Shift Workers: A Systematic Review

机译：与更长的换档持续时间较短，以减轻紧急医疗服务人员和相关转型工人的疲劳和疲劳相关风险：系统审查

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Background: This study comprehensively reviewed the literature on the impact of shorter versus longer shifts on critical and important outcomes for Emergency Medical Services (EMS) personnel and related shift worker groups. Methods: Six databases (e.g., PubMed/MEDLINE) were searched, including one website. This search was guided by a research question developed by an expert panel a priori and registered with the PROSPERO database of systematic reviews (2016:CRD42016040099). The critical outcomes of interest were patient safety and personnel safety. The important outcomes of interest were personnel performance, acute fatigue, sleep and sleep quality, retention/turnover, long-term health, burnout/stress, and cost to system. Screeners worked independently and full-text articles were assessed for relevance. Data abstracted from the retained literature were categorized as favorable, unfavorable, mixed/inconclusive, or no impact toward the shorter shift duration. This research characterized the evidence as very low, low, moderate, or high quality according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: The searched yielded n = 21,674 records. Of the 480 full-text articles reviewed, 100 reported comparisons of outcomes of interest by shift duration. We identified 24 different shift duration comparisons, most commonly 8hours versus 12hours. No one study reported findings for all 9 outcomes. Two studies reported findings linked to both critical outcomes of patient and personnel safety, 34 reported findings for one of two critical outcomes, and 64 did not report findings for critical outcomes. Fifteen studies were grouped to compare shifts 24hours versus shifts 24hours. None of the findings for the critical outcomes of patient and personnel safety were categorized as unfavorable toward shorter duration shifts (24 hours). Nine studies were favorable toward shifts 24hours for at least one of the 7 important outcomes, while findings from one study were categorized as unfavorable. Evidence quality was low or very low. Conclusions: The quality of existing evidence on the impact of shift duration on fatigue and fatigue-related risks is low or very low. Despite these limitations, this systematic review suggests that for outcomes considered critical or important to EMS personnel, shifts 24hours in duration are more favorable than shifts 24hours.
机译：背景：本研究全面审查了对较短影响的影响，对紧急医疗服务（EMS）人员和相关换班员集团的关键和重要结果的影响。方法：搜查了六个数据库（例如，PubMed / Medline），包括一个网站。此搜索是由专家小组开发的研究问题为指导先验，并以系统评价的Prospero数据库（2016：CRD42016040099）为指导。兴趣的关键结果是患者安全和人员安全。兴趣的重要成果是人员性能，急性疲劳，睡眠和睡眠质量，保留/营业额，长期健康，倦怠/压力以及系统成本。筛选者独立工作，并评估全文文章以进行相关性。从保留的文献中抽象的数据被分类为有利，不利，混合/不确定，或对较短换档持续时间的影响。这项研究根据建议，评估，开发和评估（等级）方法的评分，表征了对非常低，低，中等或高品质的证据。结果：搜索结果N = 21,674条记录。在审查的480条全文文章中，100次报告了换档期间利息结果的比较。我们确定了24个不同的换档持续时间比较，最常见的8小时与12小时。没有人研究报告所有9个结果的结果。两项研究报告了与患者和人员安全的关键结果相关的发现，34例报告了两个关键结果之一的调查结果，64个没有报告关键结果的结果。将十五个研究分组以比较换档与移位24小时相比。患者和人员安全性的关键结果的调查结果都没有被分类为不利于较短的持续时间变化（＆lt 2小时）。九项研究有利于换档，至少有7个重要成果中的至少一个，而一项研究的结果分类为不利。证据质量低或很低。结论：现有证据质量有关疲劳和疲劳相关风险的趋势持续时间的影响的质量低或非常低。尽管有这些局限性，但这种系统审查表明，对于对EMS人员来说至关重要或重要的结果，持续时间更加有利于24小时。

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