我们应该如何管理值班人员的疲劳?指导材料回顾与证据基础系统回顾。

IF 11.2 1区 医学 Q1 CLINICAL NEUROLOGY Sleep Medicine Reviews Pub Date : 2024-09-29 DOI:10.1016/j.smrv.2024.102012
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引用次数: 0

摘要

众所周知,值班工作会导致睡眠中断、疲劳和意外伤害风险增加。本综述旨在 a) 识别监管机构建议或要求的现行待命管理策略,b) 确定是否有经验证据支持这些策略来管理待命工人的疲劳。通过灰色文献检索获得了 65 份相关指导材料。通过系统的归纳主题过程,确定了这些材料中包含的一致策略:1) 轮班的规律性/可预测性;2) 疲劳管理政策;3) 规定性规则;4) 适合工作评估;5) 当日控制措施;6) 风险评估;7) 培训和教育;8) 呼叫管理。随后,一项系统性审查确定了 17 项关于待命工人疲劳管理策略有效性的原始研究。除了一些规定的工作时间限制外,针对值班人员疲劳管理策略的研究很少。这些限制通常能减少疲劳,但往往会带来增加工作量的意外后果,这可能会无意中增加整体风险。培训、教育和值班管理(如值班期间的保护性小睡)也有一些支持性证据。目前在证据方面存在的差距突出表明,亟需对量身定制的值班疲劳管理策略进行研究。
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How should we manage fatigue in on-call workers? A review of guidance materials and a systematic review of the evidence-base
On-call work is known to contribute to disrupted sleep, fatigue, and an increased risk of incidentor injury. This review aimed to a) identify current on-call management strategies that are suggested or required by regulatory bodies, and b) determine if there is empirical evidence to support these strategies in managing the fatigue of on-call workers. A grey literature search produced 65 relevant guidance materials. A systematic inductive thematic process identified consistent strategies included in these materials: 1) regularity/predictability of shifts, 2) fatigue management policy, 3) prescriptive rule sets, 4) fitness for work assessment, 5) on-the-day control measures, 6) risk assessment, 7) training and education, and 8) call management. Subsequently, a systematic review identified 17 original studies on the effectiveness of fatigue management strategies in on-call workers. Very little research has been done on fatigue management strategies for on-call workers outside of some prescriptive hours of work limitations. These limitations generally reduced fatigue, but often had the unintended consequence of increasing workload, which may inadvertently increase overall risk. Training, education, and call management (e.g., protected naps during on-call periods) also had some supporting evidence. The current gap in evidence emphasises the critical need for research on tailored on-call fatigue management strategies.
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来源期刊
Sleep Medicine Reviews
Sleep Medicine Reviews 医学-临床神经学
CiteScore
20.10
自引率
3.80%
发文量
107
期刊介绍: Sleep Medicine Reviews offers global coverage of sleep disorders, exploring their origins, diagnosis, treatment, and implications for related conditions at both individual and public health levels. Articles comprehensively review clinical information from peer-reviewed journals across various disciplines in sleep medicine, encompassing pulmonology, psychiatry, psychology, physiology, otolaryngology, pediatrics, geriatrics, cardiology, dentistry, nursing, neurology, and general medicine. The journal features narrative reviews, systematic reviews, and editorials addressing areas of controversy, debate, and future research within the field.
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