Fatigue Related Risk and Sleepiness at Work of Intern House Officers in a Teaching Hospital in Sri Lanka

Abstract

Introduction and objectives: Intern house officers are expected to work long duration shifts with frequent on-calls. Prolonged duty hours and lack of adequate sleep increase medical errors. The United Kingdom, the United States and Australia have imposed guidelines to restrict the duty hours of intern house officers. No such restriction exists in Sri Lanka and, surprisingly, there is no official off day after night on-calls. The objectives of this study were to evaluate fatigue related risk and sleepiness at work of intern house officers. Method: 31 intern house officers of the Colombo South Teaching Hospital were recruited. Duty rosters were analyzed for the length of shifts and on-calls. A self-administered questionnaire was administered to record work pattern, sleepiness and medical errors. They were categorized into three fatigue based risk groups according to the Australian Medical Council (AMA) code of practice. Epworth Sleepiness Scale was used to assess daytime sleepiness. Results: Of all, 61% were females (average age 27.5 years). All interns worked more than 70 hours a week. Based on AM C code of practice fatigue risk score, 93.5 % fell into the high risk group. 64.5 % had daytime sleepiness and 32.3 % experienced fatigue related errors. 48.3% did three or more night on-call per week and 83.9 % thought a day off after night on-call was necessary. Conclusion: Most intern house officers are at high risk for fatigue related errors and the majority is sleepy at work. A day off after the night on-call could be beneficial.