Judy (Yanjun) Chen, MD, PhD, Assistant Professor, Neuro-Ophthalmology, Department of Ophthalmology, Neurology and Neurosurgery was named Principal Investigator for a Midwest Lighting Institute sponsored project entitled: “The effect of modified lighting on unit-wide medical error rates in the UWHC Trauma and Life Support Center (TLC)”
PURPOSE
The study aims to seek evidence that modified lighting in the UWHC Trauma and Life
Support Center (TLC) work area helps reduce medical error rates.
SPECIFIC AIMS
This prospective, interventional study will compile data over a 12-month period to
investigate if modified lighting helps reduce medical error rates in the UWHC TLC work
area through the following aim:
Aim 1: We will test the hypothesis that installation of modified, blue light enriched LED
lighting at the nurse station, break rooms, common areas and elsewhere as appropriate
will reduce medical error rate in the TLC, as compared to traditional fluorescent lighting.
BACKGROUND AND SIGNIFICANCE
An increasing body of evidence has demonstrated that medical staff working long
weekly work hours and extended duration shifts are at greatly increased risk of injuring
their patients and themselves, reflected by an increase in medical error rate, propensity
to needle injuries, tendency to incurring motor vehicle accident, and deterioration in
work performance. An advanced understanding of the neurobiology of sleep and
circadian rhythm has enabled us to identify the physiological basis underlying the
negative impact of extended hour shift work on work performance and staff/patient
safety. Shift workers regularly work during the biological night when the endogenous
drive for alertness is the lowest. In addition, extended shift work hours lead to acute
sleep deprivation and accumulation of sleep debt over time.
In the United States, studies reported that medical errors affect approximately 1.3
million people yearly and account for one death per day. Despite considerable effort
made by accreditation bodies, payers, hospitals and governments to improve patient
safety, widespread improvement has not been demonstrated. There is, therefore, an
urgent need to identify and translate effective interventions to routine practice to
promote a safer healthcare environment for both patients and health care workers.
Circadian rhythms are cycles generated by an endogenous biological clock, the
suprachiasmatic nucleus (SCN) that synchronizes the majority of biological and
physiologic activities in living organisms with the 24-hour light-dark cycle. External
ambient illumination is by far the most potent stimulus entrain the circadian rhythm to
the 24-hour day, in particular, short-wavelength blue light. Studies have shown
that whereas insufficient light exposure can lead to malfunction of the circadian
system, exposure to bright light enriched in short-wavelength blue light improves
alertness and attention in normal subjects and patients with traumatic brain injury and
circadian sleep disorders. Bright light therapy has also been applied to nursing
home to help promote sleep and mood in the elderly. Little is known, however,
about whether tailored environmental light solutions in a hospital environment, including
light enriched with short-wavelength blue light to assist in staff alertness, and/or
provision of a more distinct and natural light-dark cycle for patients, can reduce medical
error rates and improve work performance of medical staffs and improve patient and
staff health and safety. The purpose of this study is to test the hypothesis that
installation of a comprehensive LED lighting program at the nurse station, break rooms,
common areas and elsewhere as appropriate in the UWHC Trauma and Life Support
Center (TLC), designed to incorporate circadian rhythm and sleep medicine principles
will reduce medical error rates as compared to the current traditional fluorescent
lighting.