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Amy Fahrenkopf, MD, MPH |
New evidence suggests that depression leads residents to make potentially
dangerous medication errors. Researchers led by Amy Fahrenkopf, MD, MPH, a pediatric hospitalist at Children's Hospital Boston, used established diagnostic
questionnaires to screen 123 pediatric residents at Children's, Lucile Packard Children's Hospital and Children's National Medical Center. Medication errors-mistakes in requesting, writing instructions for or giving medication-were tracked for one month on hospital floors.
Consistent with previous estimates, 74 percent of residents were suffering from burnout (emotional exhaustion and
detachment in response to chronic
occupational stress), and about 20 percent had depression, twice the rate in the
general United States population. While
the total medication error rate was just 0.7
percent, depressed residents made 6.2 times more errors than their colleagues. Burnout alone was not linked to higher error rates.
Most errors were minor or caught by hospital safety nets, but the potential for patient harm exists, Dr. Fahrenkopf believes. Moreover, the study didn't address other mistakes that are harder to catch
and correct, such as diagnostic errors. "The majority of these residents seemed unaware they were depressed," Dr. Fahrenkopf notes. "It's expected that you'll be miserable as a resident, so it's hard to see when unhappiness has crossed the line into illness. We need to pay more attention to residents' mental health."
The study was published online February 8 in the British Medical Journal.
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