Anesthesia, Fatigue
Conditions
Keywords
regional anaesthesia, patient safety, nerve blockade, ultrasound guided needling
Brief summary
The adverse effects of sleep related fatigue are significant, impacting on doctors' health, wellbeing, performance and ultimately their safety and that of their patients'. Trainees are at an increased risk of fatigue because they routinely, and are increasingly, working long hours, and exposed to excessive and high intensity workloads. With increasing numbers of patient consultations, there is a higher risk of making poorer quality clinical decisions (i.e. decision fatigue). The excessive workloads experienced by doctors can cause fatigue through the requirement for sustained attention over long periods of time, particularly when performing complex and mentally demanding tasks. Our main objective is to study the difference between the fatigued and non-fatigued state of anaesthetists and on their ability to perform an ultrasound-guided peripheral nerve blockade task. We hypothesise that fatigue will result in a clinically significant reduction in the objective structured assessment scores of anaesthetists who are performing an ultrasound-guided peripheral nerve blockade task compared to their scores when they are non-fatigued.
Interventions
BEHAVIORALFatigue
The intervention will be assessing the participant in a fatigued state compared to a non fatigued state
Sponsors
Nottingham University Hospitals NHS Trust
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SCREENING
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
1\. Anaesthetists of ST3 grade and above with previous experience of performing an ultrasound guided peripheral nerve block.
Exclusion criteria
1. Previous experience of gaze control training or eye-tracking software applied to medical interventions. 2. No previous experience of performing an ultrasound guided peripheral nerve block.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| composite error scoring within a regional anaesthesia performance task | 6 months | establish a comparison of mean composite error scores (CES) between participants in group F (fatigued state) and Group A (non-fatigued state) when performing a standardised ultrasound guided regional anaesthesia task. CES can range from 0 to 100. the higher the score the more negative the performance of the candidate. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global rating score (GRS) | 6 months | establish a comparison of mean Global rating scale (GRS) between participants in group F (fatigued state) and Group A (non-fatigued state) when performing a standardised ultrasound guided regional anaesthesia task. The GRS ranges from a score of 7 to a score of 35. The higher the score the better the performance. |
| Task completion time | 6 months | Compare the mean time in seconds taken by the participants in Group F and Group A to complete the standardised UGRA task. |
| Reliability of the composite error score (CES) and global rating scale (GRS) | 6 months | calculate the intra-class correlation (ICC) and Cronbach's alpha co-efficient and their associated standard error of the mean (SEM, %). |
| Eye tracking metrics | 6 months | All eye tracking-derived secondary outcome measures listed below will be calculated (and summed to create a total) for each UGRA assessment using the following pre-defined areas of interest: the ultrasound machine screen ('US screen'); their hands, the needle, the US transducer or the cadaveric model ('tools'); and any other area outside the US screen or tools ('other'). This is measures on a numerical scale on the number of times there is deviation and gaze away from the screen. The lower the number the better the performance by the candidate. |
Contacts
Primary ContactDavid W Hewson, MBBS
Backup ContactFarhaan Moosa, MBCHB
Outcome results
None listed