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Master Thesis

Impact d'une journée sans activité clinique avant une garde de réanimation sur les compétences non techniques des internes : étude de pratique contrôlée, randomisée, multicentrique, en cross-over

Abstract : Background: Working in night shift alter practician performances, as vigilance, mood, and cognitive performances. The impact of sleep loss on patient’s safety remains unclear. The impact of sleep loss may be higher on non-technical skills (NTS) than technical skills (TS), which are built on automatisms. In current practice, night shifts are preceded of a day off in some emergency departments or in some countries, but no study assessed this process. Our objective is to evaluate a schedule including no clinical activity before night shift on anesthesia (AR) and critical care (CCR) resident’s NTS after a night shift in intensive care unit (ICU). Method and analysis: This study is a prospective, randomized, single blinded trial, in cross over, assessing NTS of two AR and MIR residents’ groups according to two schedules. Residents in control schedule start working at 8:00 a.m., for a clinical day, then night shift begins at 18:00 p.m. and ends at 8:00 a.m. Residents in intervention schedule are off clinic before night shift and start at 6:00 p.m. to end at 8:00 a.m. NTS are assessed in using the Ottawa global rating scale (GRS) global score during two high fidelity simulation (HFS) sessions. Primary end point is the difference of residents’ Ottawa GRS global score at 8:00 a.m. after night shift, between the two schedules. Ottawa GRS global score will be assessed by a blinded investigator on video of HFS session. Secondary endpoints are assessment of cognitive functions implicated during crisis management, self-esteem evaluate by Rosenberg’s Self Esteem scale, sleepiness evaluate by Karolinska’s sleepiness scale, before and after night shift, difference on residents’ Ottawa GRS global score at 05:00 p.m. between the two schedules, difference of Ottawa GRS global score for each resident between 05:00 p.m. and 8:00 a.m. simulation session. Residents perform an assessment for control and intervention schedule and are randomized to start by control or intervention schedule followed by 3 months of wash out before the second schedule, we plan to include 60 residents to show a significant difference of 6 +/-11 points of Ottawa GRS global score between the two groups Conclusion: This study will provide original and robust data on managing of working time in clinic before a night shift among ICU residents. Ethics and dissemination: The study protocol has been reviewed and ethics approval obtained from the Comité Ethique pour la Recherche en Anesthésie Réanimation (CERAR, n°IRB: 00010254; #: 2021-137)). The results from this study will be actively disseminated through manuscript publications and conference presentations.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03521245
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Submitted on : Tuesday, January 11, 2022 - 2:36:22 PM
Last modification on : Thursday, January 13, 2022 - 5:00:03 AM
Long-term archiving on: : Tuesday, April 12, 2022 - 7:25:06 PM

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Vianney Duplay. Impact d'une journée sans activité clinique avant une garde de réanimation sur les compétences non techniques des internes : étude de pratique contrôlée, randomisée, multicentrique, en cross-over. Human health and pathology. 2021. ⟨dumas-03521245⟩

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