On day shift there is ususally enough MD's around to respond. Having
access or should I say, no access to MD's at night has always been a
problem. Also the response time when calling a MD at night can impact
patient outcomes.

Joan

--- In mpoweryournurses@ yahoogroups. com, "David Woodruff"
<dwoodruff@. ..> wrote:
>
> In a recent study reported in the February 20, 2008 issue of JAMA,
> Dr. Peberdy and Associates found that survival from cardiac arrests
> was worse on nightshift and on weekends. Many previous studies have
> also determined that other medical errors are higher at night and on
> weekends as well. The author suggests some explanations for the
> discrepancies such as differences in staffing levels, expertise of
> personnel, and monitoring practices.
>
> Given that staffing levels will probably always be less on nightshift
> than on dayshift, the nurses working the nightshift need to have more
> resources available to them to appropriately respond to emergency
> situations. In addition, the nightshift often hosts the more junior
> staff who may be lacking in their assessment skills. The researchers
> did not suggest a specific mechanism causing the decrease in survival
> but it is likely that a delay in assessing and/or treating the
> cardiac arrest is what caused the poor outcomes.
>
> Nightshift staff need training, mentors and additional resources so
> that they can respond appropriately to emergency situations when
> staffing is lacking.
>
> From:
> Perberdy, M.A. et al. (2008). Survival from in-hospital cardiac
> arrest during nights and weekends. JAMA, 299; 785.
>
> Best wishes,
> David W. Woodruff, MSN, RN, CNS, CEN
> President, Ed4Nurses, Inc.
> www.Ed4Nurses. com
>