夜间轮班
Initiation of a night-float system at one hospital was associated with improved outcomes.
Night Float: A Step Toward Better Obstetric Outcomes?
Initiation of a night-float system at one hospital was associated with improved outcomes.
Increasingly, labor and delivery units are being staffed at night by teams of clinicians without daytime responsibilities; however, effects on obstetric management and outcomes associated with institution of such "night-float" systems have not been well studied. Investigators at one medical center assessed practice patterns and maternal and neonatal outcomes during 3 months before and 3 months after adoption of a night-float system within one private attending physician group. Outcomes also were compared with those of another group that maintained a traditional call schedule throughout the 6-month study.
Implementation of the night-float system was associated with fewer induced labors, scheduled cesarean deliveries, episiotomies, and instances of severe perineal lacerations. Augmentation of spontaneous labor was more likely with the night-float schedule (as was initiation of oxytocin at night). In the group that retained a traditional call schedule, outcomes did not change, arguing against a global institutional change as an explanation for improvements.
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