alert fatigue

BACKGROUND AND OBJECTIVES: Work hour restriction has strained the balance between resident service and education. Night Float (NF) rotations are a popular answer to managing this balance but weakens continuity, an essential tenant of family medicine. An innovative short call system for Marshall University's Family Medicine Hospital Service (FMHS), the twINTERN call model, was created in response. We studied the impact of this approach on resident fatigue. METHODS: Anonymous surveys assessed fatigue of the Marshall University's 2013-2014 Family Medicine intern resident class while on NF rotations (ICU, Pediatrics and Surgery) and the twINTERN call...

BACKGROUND: Telemedicine has emerged as an innovative platform to diagnose and treat psychiatric disorders in a cost-effective fashion. Previous studies have laid the functional framework for monitoring and treating child psychiatric disorders electronically using videoconferencing, mobile phones (smartphones), and Web-based apps. However, phone call and text message (short message service, SMS) interventions in adolescent psychiatry are less studied than other electronic platforms. Further investigations on the development of these interventions are needed...

BACKGROUND: Pharmacogenomic clinical decision support systems (CDSS) have the potential to help overcome some of the barriers for translating pharmacogenomic knowledge into clinical routine. Before developing a prototype it is crucial for developers to know which pharmacogenomic CDSS features and user-system interactions have yet been developed, implemented and tested in previous pharmacogenomic CDSS efforts and if they have been successfully applied. We address this issue by providing an overview of the designs of user-system interactions of recently developed pharmacogenomic CDSS...

BACKGROUND: Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians...

BACKGROUND: Prompted by an article describing a dog trained to detect Clostridium difficile in patients, our institution evaluated a dog's ability to detect C. difficile scent from equipment and surfaces to assist in strategic deployment of adjunctive cleaning measures. METHODS: An expert in drug and explosives scent dog handling trained a canine to identify odours from pure cultures and/or faecal specimens positive for C. difficile. Methods used to assess explosive and drug detection dogs were adapted and included evaluation of a) odour recognition, using containers positive and negative for the scent of C...

Cardiac telemetry, designed to monitor hospitalized patients with active cardiac conditions, is highly utilized outside the intensive care unit but is also resource-intensive and produces many nonactionable alarms. In a hospital setting in which dedicated monitor watchers are set up to be the first responders to system-generated alerts, we conducted a retrospective study of the alerts produced over a continuous 2-month period to evaluate how many were intercepted before nurse notification for being nonactionable, and how many resulted in code team activations...

Digital triggers such as text messages, emails, and push alerts are designed to focus an individual on a desired goal by prompting an internal or external reaction at the appropriate time. Triggers therefore have an essential role in engaging individuals with digital interventions delivered outside of traditional health care settings, where other events in daily lives and fluctuating motivation to engage in effortful behavior exist. There is an emerging body of literature examining the use of digital triggers for short-term action and longer-term behavior change...

OBJECTIVE: The aim of this study was to examine the effects of an alertness maintaining task (AMT) in older, fatigued drivers. BACKGROUND: Fatigue during driving increases crash risk, and previous research suggests that alertness and driving in younger adults may be improved using a secondary AMT during boring, fatigue-eliciting drives. However, the potential impact of an AMT on driving has not been investigated in older drivers whose ability to complete dual tasks has been shown to decline and therefore may be negatively affected with an AMT in driving...

OBJECTIVE: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. METHODS: We performed a retrospective study of medication alerts over a 24-month period (1/2013-12/2014) in a large pediatric academic medical center...

OBJECTIVE: To determine how much moderate-intensity physical activity, in the form of walking, could be prescribed for people living in the community after hip fracture in terms of safety, tolerability and feasibility. DESIGN: Phase I dose-response design. SETTING: Participants were recruited from two public community rehabilitation centres in Melbourne, Australia. PARTICIPANTS: Community-dwelling adults (n=21, 16 women, mean age ± SD, 75 ± 9 years) who were cognitively alert, attending community rehabilitation after a hip fracture (mean ± SD days post fracture, 110 ± 47 days), able to walk with or without a gait aid and for whom it was safe to participate in physical activity...

INTRODUCTION: Voice communication may enhance performance during monotonous, potentially fatiguing driving conditions (Atchley & Chan, 2011); however, it is unclear whether safety benefits of conversation are outweighed by costs. The present study tested whether personalized conversations intended to simulate hands-free cell phone conversation may counter objective and subjective fatigue effects elicited by vehicle automation. METHOD: A passive fatigue state (Desmond & Hancock, 2001), characterized by disengagement from the task, was induced using full vehicle automation prior to drivers resuming full control over the driving simulator...

BACKGROUND: Since clinical management of heart failure relies on weights that are self-reported by the patient, errors in reporting will negatively impact the ability of health care professionals to offer timely and effective preventive care. Errors might often result from rounding, or more generally from individual preferences for numbers ending in certain digits, such as 0 or 5. We apply fraud detection methods to assess preferences for numbers ending in these digits in order to inform medical decision making...

For drivers on monotonous routes, cognitive fatigue causes discomfort and poses an important risk for traffic safety. Countermeasures against this type of fatigue are required and thermal stimulation is one intervention method. Surprisingly, there are hardly studies available to measure the effect of cooling while driving. Hence, to better understand the effect of short-term cooling on the perceived sleepiness of car drivers, a driving simulator study (n = 34) was conducted in which physiological and vehicular data during cooling and control conditions were compared...

Fatigue is an identifiable and preventable cause of accidents in transport operations. Regarding the railway sector, incident logs and simulation studies show that employee fatigue leads to lack of alertness, impaired performance, and occurrence of incidents. China has one of the largest rail systems in the world, and Chinese railway employees work under high fatigue risks; therefore, it is important to assess their fatigue level and find the major factors leading to fatigue. We designed a questionnaire that uses Multidimensional Fatigue Instrument (MFI-20), NASA-TLX and subjective rating of work overtime feelings to assess employee fatigue...

Mental fatigue, a state of reduced alertness and decreased overall performance due to prolonged cognitive activity, is a major cause for a large number of accidents in traffic and industry. Against the background of an aging workforce, the investigation of the interconnection of mental fatigue and aging is of great practical relevance. In the present study, a group of younger and a group of older adults performed a cognitive task for 3h. The experimental design also comprised breaks with various durations. Beside behavioral data, the spectral properties of the ongoing EEG with respect to time on task and breaks were analyzed...

BACKGROUND: Although alert fatigue is blamed for high override rates in contemporary clinical decision support systems, the concept of alert fatigue is poorly defined. We tested hypotheses arising from two possible alert fatigue mechanisms: (A) cognitive overload associated with amount of work, complexity of work, and effort distinguishing informative from uninformative alerts, and (B) desensitization from repeated exposure to the same alert over time. METHODS: Retrospective cohort study using electronic health record data (both drug alerts and clinical practice reminders) from January 2010 through June 2013 from 112 ambulatory primary care clinicians...

Importance: Bedside monitor alarms alert nurses to life-threatening physiologic changes among patients, but the response times of nurses are slow. Objective: To identify factors associated with physiologic monitor alarm response time. Design, Setting, and Participants: This prospective cohort study used 551 hours of video-recorded care administered by 38 nurses to 100 children in a children's hospital medical unit between July 22, 2014, and November 11, 2015...

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INTRODUCTION: Energy drinks are popular beverages that are supposed to counteract sleepiness, increase energy, maintain alertness and reduce symptoms of hangover. Cognitive enhancing seems to be related to many compounds such as caffeine, taurine and vitamins. Currently, users mostly combine psychostimulant effects of energy drinks to counteract sedative effects of alcohol. However, recent literature suggests that this combination conducts to feel less intoxicated but still impaired. The goal of the present article is to review cognitive impact and subjective awareness in case of caffeinated alcoholic beverage (CAB) intoxication...

Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy...