A Prospective Observational Study of the Effect of Night Duty on the Cognitive Function of Anaesthetic Registrars

Abstract

The issue of fatigue in hospital medical staff represents a potential health and safety risk to both staff and patients, and is receiving worldwide interest. We aimed to characterize the cognitive performance of anaesthetic registrars before and after a series of night shifts. We enrolled nine full-time anaesthetic trainees in an Australian adult tertiary-referral hospital. We conducted a cross-over observational study which tested cognitive performance in participants before and after seven consecutive night shifts and compared this with performance before and after seven consecutive day shifts. Cognitive function was measured using a computerized assessment tool. Participants completed a mean of 62.5% of the requested testing (seven participants completed 87%). There was no significant change in performance before or after any day shift, nor at the commencement of each night shift. There was near perfect accuracy in performance in all tests at all times. There was a statistically significant deterioration in speed of performance for detection and identification tasks at the end of night shift as the week progressed. Anaesthetic registrars demonstrate a significant decline in cognitive performance after a series of night shifts.