Focus on Prehospital Providers Sleep Quality and Fatigue among Prehospital Providers

Background. Fatigue is common among medical professionals and has been linked to poor performance and medical error. Objective. To characterize sleep quality and its association with severe fatigue in emergency medical services (EMS) providers. Methods. We studied a convenience sample of EMS providers who completed three surveys: the Pittsburgh Sleep Quality Index (PSQI), the Chalder Fatigue Questionnaire (CFQ), and a demographic survey. We used established measures to examine survey psychometrics and performed t-tests, analysis of variance (ANOVA), and chisquare tests to identify differences in PSQI and CFQ scores. Results. One hundred nineteen surveys were completed. The eight-hour shift was most commonly reported (35.4%). A majority of subjects were overweight (41.9%) or obese (42.7%), and 59.6% had been diagnosed with one or more health conditions (e.g., diabetes). Results from psychometric tests were positive. The mean (± standard deviation) PSQI score was Received June 3, 2009, from the Department of Emergency Medicine, University of Pittsburgh School of Medicine (PDP, BPS, MDW, DH), Pittsburgh, Pernnsylvania; and the Department of Emergency Medicine, Geisinger Health System (DFK), Danville, Pennsylvania.. Revision received August 6, 2009; accepted for publication August 24, 2009. Presented in part at the National Association of EMS Physicians annual meeting, Jacksonville, Florida, January 2009. During the execution of this study, Dr. Patterson was supported by the Society for Academic Emergency Medicine/Emergency Medicine Patient Safety Foundation (SAEM/EMPSF) Patient Safety Fellowship. Currently, Dr. Patterson is supported by a KL2 career development grant (Grant Number KL2 RR024154) from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of SAEM/EMPSF, the NCRR, or the NIH. This article is not subject to U.S. copyright law. Address correspondence and reprint requests to: P. Daniel Patterson, PhD, Department of Emergency Medicine, University of Pittsburgh School of Medicine, 3600 Forbes Avenue, Iroquois Building, Suite 400A, Pittsburgh, PA 15261. e-mail: [email protected] doi: 10.3109/10903120903524971 9.2 (± 3.7). A CFQ score ≥4, indicating severe mental and physical fatigue, was present in 44.5% of the subjects. The mean PSQI score was higher among those reporting severe fatigue (11.3 ± 3.2) than among those not reporting fatigue (7.5 ± 3.0, p < 0.0001). Conclusions. The results from this study suggest that the sleep quality and fatigue status of EMS workers are at unhealthy levels. The health and safety of the EMS worker and patient population should be considered in light of these results.