Fatigue and anaesthetists (The Association of Anaesthetists of Great Britain & Ireland, 2014)

Summary

This consensus document by The Association of Anaesthetists of Great Britain & Ireland aims to improve patient safety. It is intended to act as a reference document for individuals and departments when considering the effects of hours of work and type of work undertaken in anaesthesia on clinician’s performance and wellbeing.

Content

Recommendations

• In keeping with the General Medical Council (GMC) guidance in Good Medical Practice, every doctor is required to provide safe and effective care and therefore should be aware of the issues of fatigue.
• Departments must have a plan to manage staff of all grades who have undertaken an onerous duty period and consider themselves unfit to continue work.
• Job plans should be constructed such that they are not likely to lead to predictable fatigue.
• Routine rest breaks should be implemented.
• Handover protocols should be used before and after every rest break.
• Rest facilities and on-call rooms should be available for staff to nap during shifts or sleep post-call.
• Resident on-call staff should have suitable accommodation.
• Refreshments should be available at all times.
• On-call responsibilities should be reviewed regularly and, particularly in the older anaesthetist, take into consideration subjective assessment of fatigue (consider seeking advice from an accredited specialist in occupational medicine).
• Education on fatigue, its causes, mitigating factors, and its impact on healthcare should be a priority for anaesthesia departments.