Navigate Up
UPMC/University of Pittsburgh Schools of the Health Sciences
Director
Telephone: 412-586-9777
Senior Manager
Telephone: 412-578-9193 or 412-624-3212

Video Resources

 

Watch the YouTube video of Dr. Patterson discussing his new research on fatigue and EMS safety.

University of Pittsburgh Schools of the Health Sciences 

Fatigue Linked to Safety Problems Among EMS Workers, Pitt Study Finds

PITTSBURGH, Nov. 17, 2011  Fatigue and poor sleep quality, which affect many emergency medical services (EMS)  workers, are linked to higher reported rates of injuries, medical errors and safety-compromising behaviors, according to a study by University of Pittsburgh researchers that is now available online in Prehospital Emergency Care and appearing in the January-March 2012 print edition.

“Emergency medical technicians and paramedics work long hours in a demanding occupation with an unpredictable workload, which can easily lead to fatigue and poor sleep. Our study is one of the first to show that this may jeopardize patient and provider safety in the EMS setting,” said lead author P. Daniel Patterson, Ph.D., EMT-B, an assistant professor in the Department of Emergency Medicine at the University of Pittsburgh School of Medicine.

Dr. Patterson and his colleagues surveyed EMS workers from across the country, receiving complete data from 511 respondents. A previously tested tool called the Pittsburgh Sleep Quality Index was used to evaluate sleep quality, including such factors as sleep duration and use of sleeping medication. A questionnaire measuring fatigue and adapted for the EMS environment was used to assess physical and mental fatigue. The researchers also developed a new 44-item survey tool to elicit self-reported safety outcomes data, including provider injury, medical errors or adverse events and safety-compromising behaviors, such as excessive speeding.

In the survey sample, more than half of the respondents were classified as fatigued; 18 percent reported an injury; 41 percent reported a medical error or adverse event; and 90 percent reported a safety-compromising behavior. After controlling for extraneous variables, the researchers found the odds of injury were 1.9 times greater for fatigued respondents vs. their non-fatigued peers; the odds of medical errors or adverse events were 2.2 times greater; and the odds of safety-compromising behavior were 3.6 times greater. 

Most survey respondents reported working between six and 15 shifts per month, and half reported regular shift lengths of 24 hours. A third of the respondents were regularly working at more than one EMS agency. In the sample, the number of shifts worked monthly was linked to reported errors and adverse events but not to injury or perceptions of compromised safety. Longer shift hours were not associated with higher odds of negative safety outcomes—perhaps because the study did not measure the varying workloads and ability to rest during each shift, the researchers speculated.

“While further research is needed to examine the association between self-reported and actual safety outcomes, our findings provide preliminary evidence that sleep quality and fatigue are important indicators of EMS safety,” said Dr. Patterson. “Our data also suggest that number of shifts and total fatigue, instead of shift length, may be important targets for intervention in this workforce.”

In addition to Dr. Patterson, study authors include Matthew D. Weaver,  Rachel C. Frank, Charles W. Warner, Christian Martin-Gill, M.D.,  Francis X. Guyette, M.D., Clifton W. Callaway, M.D., and David Hostler, Ph.D., all of the University of Pittsburgh School of Medicine; Thomas J. Songer, Ph.D., and Sheryl F. Kelsey, Ph.D., of the University of Pittsburgh Graduate School of Public Health; Rollin J. Fairbanks, M.D., of the National Center for Human Factors Engineering in Healthcare in Washington, D.C.; and Michael W. Hubble, Ph.D., of Western Carolina University.

The research was supported by grants from the Pittsburgh Emergency Medicine Foundation and North Central EMS Institute. Dr. Patterson is supported by an early investigator training grant from the National Center for Research Resources, part of the National Institutes of Health.

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com