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Published May 2016
- AMA - Managing the Risks of Fatigue in General Practice - For GPs and GP Registrars 2008 View Link
The AMA has produced a Fatigue risk checklist to help doctors monitor their risk of fatigue based on their work routine over the previous 7 days¹.
|Lower Risk||Significant Risk||Higher Risk|
|Less than 50 hours worked||50 to 70 hours worked||More than 70 hours worked|
|No more than 10 consecutive hours in any one period||Up to 14 consecutive hours in any one period||14 or more consecutive hours worked at least twice|
|3 or more short breaks taken during daily working hours||1 or 2 short breaks during daily working hours||No short breaks during daily working hours|
|Little or no unscheduled extra work||More than 10 hours extra unscheduled work||More than 20 hours unscheduled extra work|
|Scheduled on call for less than 3 days in 7 days||Scheduled on call for 3 days or more in a 7 day period||Scheduled on call continuously for more than a 7 day period|
|No night work||At least 2 nights of work or extended hours into the night||At least 3 nights of work or extened hours into the night|
|Minimum 10 hour breaks between work periods and 2 days free of work||Minimum 10 hour breaks between work periods and one day free of work||Less than minimum 10 hours break on at least two work periods and no full day free of work|
|No changes to work schedule without notice||Changes to work schedule through additional hours and call outs worked||Work schedule changed so much because of additional hours and call outs so as to become unpredictable|
|Maximum opportunity for sleep to be taken at night, including 2 full nights of sleep||About two-thirds of sleep able to be taken at night including 1 full night of sleep||Less than half of sleep able to be taken at night and no opportunity for 1 full night of sleep|
The impact of fatigue is serious and it has been linked with higher risks of medical error. Performance impairment following 18 hours of sustained wakefulness is similar to having a blood alcohol reading of greater than 0.05%.
If you are at risk of fatigue, we encourage you to consider making changes to your work schedule.
Tips for designing your work schedule
In designing your work schedule, you should try to:
- Minimise the occasions where you are required to work more than 10 hours in a shift
- Ensure that you can get a minimum of 8 hours sleep between the end of one shift and starting work again
- Ensure that any period of extended hours is compensated for with a longer break before starting work again
- Ensure you have regular time (a minimum of 24 hours) free of work in a 7 day period in which unrestricted sleep is possible
- Ensure that you have a longer break between, and following, nightshifts
- Maximise the opportunities to take short breaks while at work.