The influence of a night-float call system on the incidence of unintentional dural puncture: A retrospective impact study

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Implementation of night float increased the incidence of unintentional dural puncture.