A disturbing study in the Journal of the American Medical Association shows that “nocturnists” – hospitalists who specializes in night work – must be vigilant to ensure patient safety.
The JAMA study found that hospital patients had a lower rate of surviving cardiac arrest at night than they did if they arrested during the day. The comprehensive study was published in February of 2008, but since then hospitals have responded with creative ideas to close the gap in care.
Hospital consultant Dr. John Nelson coined the term nocturnist to describe the health care professionals that hospitals are hiring to help improve response times and patient safety. Nelson said the role of a nocturnist has risen sharply in the past decade with as many as 1,500 nocturnists working in hospitals today compared to about 100 only 10 years ago.
The Institute for Healthcare Improvement hosted a seminar on the subject in December. The IHI brought a quality control consultant from Wales, U.K., a pediatrics professor from Cincinnati and a Springfield, Mass. medical director to the seminar to discuss the ideas being used to close the gap in care.
The group discussed the challenges hospitals face in providing quality care to patients at night, including patients who put off calling an attending physician until the morning. They also discussed the special training being implemented recently to help professionals recognize patient needs as the patients themselves are more likely to overlook issues because of being at rest.
Doctors at Virginia Commonwealth University in Richmond looked at adult cardiac arrest survival rates by time of day and day of week in hopes that the findings could inform hospital staffing, training and equipment decisions, according to the JAMA.
The study looked at about 86,000 in-hospital cardiac arrests in 507 medical/surgical hospitals over a seven-year period. About 58,000 of those cardiac arrests happened during daytime or evening hours and about 28,000 cases happened at night.
Researchers found discrepancies in all of the data they observed, but survival to discharge was the most significant. Patients who went into cardiac arrest during the daytime or evening hours were five percent more likely to survive than patients who arrested at night. Weekend rates were similar to night rates, according to the study.
“The principal finding of this study was that survival to discharge following in-hospital cardiac arrest was lower [when the arrest occurred] during nights and weekends compared with day/evening times on weekdays, even after accounting for many potentially confounding patient, arrest event, and hospital factors,” the authors wrote.
Individuals and their loved ones who are experiencing pain and suffering after a nighttime incident at a hospital can have their rights upheld by a medical malpractice attorney.
Robert Briskman is a Chicago medical malpractice lawyer and Chicago medical malpractice attorney with Briskman Briskman & Greenberg. To learn more call 1.877.595.4878 or visit http://www.briskmanandbriskman.com/.
