by Anthony J. Brown, MD
Last Updated: 2009-11-06 16:29:35 -0400 (Reuters Health)
NEW YORK (Reuters Health) – Intensive care unit (ICU) nurses are more likely than floor nurses to have abnormal sleep and to experience a drop in vigilance during their shift that could impair patient safety, according to study findings presented this week at the CHEST 2009 meeting in San Diego, California.
"Nurses working in the ICU tend to have abnormal sleep and tend to have a greater frequency of errors across the length of their shift," lead researcher Dr. Salim R. Surani told Reuters Health. "These findings could be explained on the basis of the ICU nurses having a more impaired sleep quality as seen by PSQI (Pittsburg Sleep Quality Index), and perhaps having a more demanding and intensive work schedule in the ICU as compared to the floor."
Dr. Surani and colleagues from Baylor College of Medicine, Houston, decided to investigate this topic after noting that while several studies have looked at sleepiness and medical errors among medical residents and shift workers, few have examined these issues in ICU nurses.
When they assessed ICU and floor nurses using the psychomotor vigilance test (PVT), the researchers found that ICU nurses made more errors at both the beginning and end of their shift than did floor nurses. Moreover, as their shifts progressed, the ICU nurses made more errors (p = 0.029), while floor nurses showed no change.
As noted, ICU nurses had significantly worse PSQI scores than did floor nurses (p = 0.041). Scores on the Epworth and Stanford sleepiness scales, however, were similar in the two groups.
"The disturbed sleep and decreased alertness (seen in ICU nurses) may have serious implications for the individual as well as in patient safety," Dr. Surani emphasized. Further research, he added, is needed to clarify the association between sleepiness and medical errors.
