Summary of "Effects of fatigue on anaesthetist well-being and patient safety: a narrative review"

Summary published November 18, 2024

Summary by Jayashree Sood, MD; Bhuwan Chand Panday, MD

British Journal of Anaesthesia | April 2024

Ippolito M, Einav S, Giarratano A, Cortegiani A. Effects of fatigue on anaesthetist well-being and patient safety: a narrative review. Br J Anaesth. 2024 Jul;133(1):111-117. doi: 10.1016/j.bja.2024.03.017. Epub 2024 Apr 19. PMID: 38641516.

doi: https://doi.org/10.1016/j.bja.2024.03.017

This narrative review assesses the intricate, prolonged, and challenging working conditions of anesthesia professionals, which result in physical and mental exhaustion that impacts patient outcomes. Key findings include:

  • Workplace fatigue is common among anesthesia professionals: The Australian Medical Association (2016) concluded that 75% of intensivists and 31% of anaesthetists are at an elevated risk of exhaustion due to their workload.
  • Anesthesia providers are essential to the provision of emergency care, but consequently are often expected to work extended hours and endure frequent changes in duty and shift schedules, contributing to fatigue.
  • The risks for patients from anesthesia provider fatigue are well-described, with one recent survey of 6,000 anesthesia providers finding that 74% believed that their fatigue during night work could increase perioperative risk for their patients and 81% believed that “night work represents an additional risk per se for their patients.”
  • Another study noted that the incidence of death during ICU admissions occurring on the weekend was higher than weekday admissions, potentially attributable to pressures to deliver in a hurry, disorganisation, inadequate handover, and poor communication.
  • Fatigue can also negatively affect anesthesia provider well-being: a survey conducted by the American Society of Anesthesiologists revealed that among 3,898 anesthesiologist members, 59.2% were at an elevated risk of burnout, while 13.8% satisfied the criteria for burnout syndrome as per the Maslach Burnout Inventory.
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