The Influence of a Night-Float Call System on the Incidence of Unintentional Dural Puncture: A Retrospective Impact Study.

Abstract

Resident night-float systems have been associated with adverse outcomes. We hypothesized that an obstetric anesthesia night float would increase the incidence of unintentional dural punctures. The July to December incidence of unintentional dural puncture before (control group) and with night float (night-float group) was compared retrospectively. The incidence of unintentional dural puncture by day of week and trainee level was evaluated. The unintentional dural puncture rate of control group was 0.73% (20 of 2758) vs 1.49% (39 of 2612) in the night-float group (P = 0.008; relative risk = 2.06; 95% confidence interval = 1.23-3.74). The proportion of unintentional dural punctures attributed to clinical anesthesia-1 residents in the night-float and control groups was 28.2% (11 of 39) and 5.0% (1 of 20), respectively (relative risk = 5.64; 95% confidence interval = 1.07-152; P = 0.044). Implementation of night float increased the incidence of unintentional dural puncture.