Iç Hastalıkları Yoğun Bakım Ünitesi'nde Çalışan Birinci Yıl Araştırma Görevlilerinin Rotasyonları Sırasında Ilk Çalışma Haftalarındaki Uyum Sürecinin Mortalite Üzerine Etkisi

Abstract

Aim: The primary aim of this study is to determine whether there is any effect of adaptation of internal medicine residents during their first week rotation period in the medical intensive care unit on patient mortality. Methods: Patients who were admitted to Hacettepe University Medical Intensive Care Unit between January 2008 and June 2013 were included in the study. Readmissions were excluded. Parameters such as APACHE II score, hospital acquired infection rate and experience of residents were used to determine the influence of these parameters on 30th day mortality and hospital mortality. Results: In multivariate analysis, 30th day mortality and hospital mortality rates increased during the first week of internal medicine residents’ rotations compared to other work weeks (p=0.06 and 0.02, respectively). When each year’s mortality risk was compared to that of 2008, 30th day mortality and hospital mortality rates of 2011, 2012 and 2013 were higher than mortality rates of other years (for 30th day mortality, p=0.01, 0.05 and 0.08, respectively). Rise in the APACHE II score and presence of hospital acquired infection increased the risk of 30th day mortality (p<0.01 and p=0.02, respectively). Conclusion: In units where critically ill patients are admitted, such as intensive care units, rotation programs of residents should be planned to minimize the number of inexperienced residents.