Yael van der Geest, Ivan Chau, Pedro David Wendel-Garcia, Philipp K Buehler, Wolf Hautz, Miodrag Filipovic, Daniel A Hofmaenner, Urs Pietsch
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引用次数: 0
Abstract
Background: The handover and associated shift start checks by nurses of critical care patients are complex and prone to errors. However, which aspects lead to errors remains unknown. Fewer errors might occur in a structured approach. We hypothesized that specific gaze behavior during handover and shift start safety check correlates with error recognition.
Methods: In our observational eye tracking study, we analyzed gaze behavior of critical care nurses during handover and shift start safety check in a simulation room with built-in errors. Four areas of interest (AOI) were pre-defined (patient, respirator, prescriptions, monitor). The primary outcome were different gaze metrics (time to first fixation, revisits, first visual intake duration, average visual intake duration, dwell time) on AOIs. Parameters were analyzed by taking all errors in account, and by dividing them into minor and critical.
Results: Forty-three participants were included. All participants committed at least a minor error (n = 43, 100%), at least one critical error occurred in 29 participants (67%). Taking all errors into account, longer time to first fixation and more revisits were associated with an increased risk of missing errors (Time to First Fixation: OR 1.099 (95% CI 1.023-1.191, p = 0.0002), Revisits: OR 1.080 (95% CI 1.025-1.143, p = 0.0055)).
Conclusion: Error detection during shift start safety check was associated with distinct gaze behavior. Nurses who recognized more errors had a shorter time to first fixation and less revisits. These gaze characteristics might correspond to a more structured approach. Further research is necessary, for example by implementing a checklist, to reduce errors in the future and improve patient safety.
期刊介绍：
The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.
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