Human factors in healthcare最新文献

{"title":"Nurse-centered co-design of an electronic health record nursing summary","authors":"Suhyun Park ,&nbsp;Jenna Marquard","doi":"10.1016/j.hfh.2024.100065","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100065","url":null,"abstract":"<div><h3>Background</h3><p>Electronic health record (EHR) nursing summaries have the potential to support nurses in locating and synthesizing patient information. However, nurses’ role-specific perspectives are often excluded in the design of the EHR system. The purpose of this study was to describe nurses’ current use of nursing summaries and vital sign information within them and glean their ideas for design improvements.</p></div><div><h3>Methods</h3><p>This research followed Nielsen and Norman's 4-phased design cycle and focused on the discovery and exploration phases to identify the context of nurses' use of the nursing summary (discovery) and to create prototype design layout using physical materials (exploration).</p></div><div><h3>Results</h3><p>Ten clinical inpatient nurses participated in interviews and co-design activities. Nurses hardly use the nursing summary to overview a comprehensive patient's health status. The current design of a nursing summary lacks comprehensive patient information and contains much irrelevant data. Nurses prefer vital signs to be prominently displayed on the summary screen for easy visibility.</p></div><div><h3>Conclusion</h3><p>Involving nurses in the design process can lead to a nursing summary that better meets their needs.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100065"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000022/pdfft?md5=eded2a5e7a0c533fecf94d3ed25ff2a9&pid=1-s2.0-S2772501424000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139487700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing feedback visualizations to support older adults’ medication adherence","authors":"Qiong Nie ,&nbsp;Daniel G. Morrow ,&nbsp;Renato F.L. Azevedo ,&nbsp;Wendy A. Rogers","doi":"10.1016/j.hfh.2024.100076","DOIUrl":"10.1016/j.hfh.2024.100076","url":null,"abstract":"<div><h3>Background</h3><p>Blood pressure control is critical for older adults because the prevalence of hypertension and resulting cardiovascular illness increases with age. Antihypertension medications are central to blood pressure treatment. However, nonadherence to antihypertension medications is high. Health technology such as smartphone apps provide an opportunity for users to manage their medication regimen and support processes related to medication-taking.</p></div><div><h3>Objective</h3><p>We implemented a user-centered evaluation approach to develop and refine adherence feedback visualizations for the MEDSReM© medication adherence app for older adults with hypertension.</p></div><div><h3>Methods</h3><p>We conducted a literature review and iterative usability testing to achieve this objective. We identified adherence goals, information needs, as well as design guidelines by reviewing theoretical frameworks and existing scientific evidence. We then used a two-phase iterative user-centered study and subject matter expert evaluation. Both quantitative and qualitative data were used to select and improve the current prototype and evolve to the next prototype.</p></div><div><h3>Results</h3><p>The need for daily, weekly, and monthly adherence performance information as well as visualization formats for conveying this information was identified from the literature review. Overall, the information shown in visualization prototypes was successfully interpreted by participants. Comprehension issues of visualizations were identified and addressed from visual prototype revisions. Insights from both user and subject matter expert groups were used to select and refine the prototypes for the MEDSReM app.</p></div><div><h3>Conclusion</h3><p>Evidence-based and user-centered approaches were effective for developing visualizations about adherence performance feedback in the MEDSReM app and provided insight into how the app can be made easy to understand and use by older adults with hypertension, which will be evaluated in future effectiveness testing.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100076"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000137/pdfft?md5=2a91d2a0570d83daf35d7f9f14a4aeb3&pid=1-s2.0-S2772501424000137-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141136068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying barriers to implementation of the medicare annual wellness visit for patients of a rural federally qualified health center","authors":"David E. Beal ,&nbsp;Vicki L. Simpson ,&nbsp;Brandon J. Pitts ,&nbsp;Jennifer A. Coddington","doi":"10.1016/j.hfh.2024.100077","DOIUrl":"10.1016/j.hfh.2024.100077","url":null,"abstract":"<div><p>As the population ages, the Medicare Annual Wellness Visit provides an opportunity to address determinants of health and improve quality of life. It is designed to help practitioners provide evidence-based health promotion, disease prevention, and wellness recommendations to Medicare beneficiaries. While barriers to its use have been described in the literature, there is a lack of studies describing why underutilization of the Medicare benefit is worse in rural compared to non-rural areas. This study used the Human Factors Conceptual Framework to Map-Assess-Recognize-Conclude (HF-MARC) as a conceptual framework to identify barriers of Medicare Annual Wellness Visit use at two nurse-led rural Federally Qualified Health Centers in Midwest United States. Data were collected through a survey, two interviews, and review of organizational documents. After integrating the data, results revealed that socioeconomic barriers, inefficient data collection processes, marginally acceptable data collection tools, organizational policies, and rural recruitment and retention challenges may play a role in the low utilization of the Medicare benefit at the studied rural clinics. Similar rural practices should focus on improving workflow to deliver a level of benefit to patients which exceeds the opportunity costs they incur by attending the visit. Policymakers should fund public health initiatives which promote healthy aging.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100077"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000149/pdfft?md5=6d2281cc1568b831a5ba320c1b91f532&pid=1-s2.0-S2772501424000149-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mechanical device for precise self-administration of ocular drugs","authors":"Jesse George-Akpenyi ,&nbsp;Benjamin Lahner ,&nbsp;Seung Hyeon Shim ,&nbsp;Carly Smith ,&nbsp;Nakul Singh ,&nbsp;Matt Murphy ,&nbsp;Leroy Sibanda ,&nbsp;Giovanni Traverso ,&nbsp;Nevan C. Hanumara","doi":"10.1016/j.hfh.2024.100074","DOIUrl":"10.1016/j.hfh.2024.100074","url":null,"abstract":"<div><p>Individuals with glaucoma are routinely prescribed and required to self-administer eye drop-based medication multiple times a day. Unfortunately, the process of self-administering eye drops requires a level of dexterity, strength, and visual acuity that the elderly population often do not possess, resulting in poor adherence and worsening condition. In this paper, we detail a prototyped eye drop assist device designed to safely and reliably deliver prescription medications. The ergonomic device safely anchors the eye drop bottle tip an optimal distance away from the face, aligns to the pupil, and provides feedback to the user when their head is at an appropriate tilt for a successful eye drop administration. We experimentally verify that the device improves hand steadiness, provides accurate head tilt feedback, precisely positions the bottle tip, and predictably delivers eye drops into the eye according to a parameterized model.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100074"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000113/pdfft?md5=220c0b7b11fa86828a1c9e2151a7294d&pid=1-s2.0-S2772501424000113-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting engagement with a patient portal in a tertiary children's hospital: A qualitative study","authors":"Lauren Vickery,&nbsp;Melanie Keep,&nbsp;Anna Janssen","doi":"10.1016/j.hfh.2023.100063","DOIUrl":"https://doi.org/10.1016/j.hfh.2023.100063","url":null,"abstract":"<div><h3>Background</h3><p>Patient portals have been shown to be beneficial for caregivers of children with chronic diseases, simplifying appointment-booking processes and improving communication between healthcare teams and families. However, there is low uptake of patient portals in this community. Despite some research into barriers of portal use among adults with chronic conditions, there is limited understanding of barriers to portal use among parents of children with chronic conditions. This study aimed to explore the perceived barriers to engaging with a patient portal among caregivers of children attending a tertiary children's hospital.</p></div><div><h3>Materials and methods</h3><p>A qualitative study was conducted with a purposive sample of participants (<em>n</em> = 7) who were caregivers of patients at a tertiary children's hospital, and not using the patient portal. Semi-structured interviews were audio recorded, transcribed and deidentified before being thematically analysed using the Technology Acceptance Model (TAM).</p></div><div><h3>Results</h3><p>Six themes emerged; four fit into the two TAM categories: perceived ease of use (technical difficulties and patient portal design) and perceived usefulness (existing system and process, and appropriateness for patient context). Two additional factors were found: awareness of the patient portal and attitudes towards technology.</p></div><div><h3>Conclusions</h3><p>Participants identified barriers to patient portal uptake that broadly aligned with the TAM and with barriers affecting self-managing adults. The need for the portal to be easily integrated into caregivers’ busy schedules appeared to be more evident in this study than in those exploring factors affecting self-managing adults.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100063"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501423000301/pdfft?md5=50d53501693ed26827ab7301cc9a5e4a&pid=1-s2.0-S2772501423000301-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139493774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kitchen ergonomics in health and healthcare: A rapid scoping review","authors":"Haozhi Chen ,&nbsp;Nicholas Anton ,&nbsp;Richard J. Holden ,&nbsp;Denny Yu","doi":"10.1016/j.hfh.2024.100069","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100069","url":null,"abstract":"<div><p>Although traditional workplace settings such as hospitals and clinics are well-studied, non-clinical areas like home kitchens, which connect clinical healthcare with the care provided in daily living settings, have received less attention. During the early stages of the global pandemic, there has been an increase in home cooking activities due to widespread isolation and restrictions imposed on dining publicly. Ergonomics is at the intersection between work environments and human task performance, and kitchen ergonomics informs knowledge on effective, safe, and efficient cooking practices while maintaining the desired kitchen functionality. Numerous contributions across various disciplines have added knowledge to the kitchen ergonomics area, and this rapid scoping review aims to synthesize the knowledge from these diverse disciplines and further understanding of user interactions with home kitchens. Adopting the Systems Engineering Initiative for Patient Safety model, relevant research publications were synthesized into four major themes: Kitchen layout, arrangement, and environment; Kitchen tools and technology; Design criterion for users with special needs; Risks &amp; Hazards related to kitchen activities. These themes summarizes the current state and gaps in kitchen ergonomics. In addition, these themes help identify future engineering opportunities for supporting health-related cooking activities in the home environment.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100069"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277250142400006X/pdfft?md5=be51919d9b0fa3004667307903a08b20&pid=1-s2.0-S277250142400006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140536112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positioning humility within healthcare delivery - From doctors’ and nurses’ perspectives","authors":"Barret Michalec ,&nbsp;Monica M. Cuddy ,&nbsp;Kaitlyn Felix ,&nbsp;Rachel Gur-Arie ,&nbsp;Jon C. Tilburt ,&nbsp;Frederic W. Hafferty","doi":"10.1016/j.hfh.2023.100061","DOIUrl":"https://doi.org/10.1016/j.hfh.2023.100061","url":null,"abstract":"<div><h3>Objective</h3><p>Explore the roles of humility in healthcare delivery from perspectives of active doctors and nurses.</p></div><div><h3>Background</h3><p>Although the concept of humility has gained attention in the healthcare and health professions education fields, previous literature has primarily been anecdotal reflections or conceptual explorations, leaving a gap of empirical approaches to what humility “looks like” in healthcare.</p></div><div><h3>Methods</h3><p>Three hundred and five active U.S.-based doctors and nurses completed a survey containing close- and open-ended questions examining their experiences with and perceptions of humility in the clinical care setting.</p></div><div><h3>Results</h3><p>The findings from this study echo previous literature touting the value of humility in regard to patient care, but also spotlight the connections between humility and status, how humility acts as a leveling mechanism, and humility's roles regarding facilitating collaborative, team-based care. We also find evidence of the effects of intellectual humility, as well as the tenets of the professional humility concept.</p></div><div><h3>Conclusion</h3><p>According to doctors and nurses, humility is essential to high quality team-based, patient-centered care, but there is an explicit connection between humility and status – specifically related to the occupational status embedded within healthcare delivery. Future research should investigate not only how humility may facilitate interprofessionalism, but also the roles and impact of humility regarding uncertainty, and the processes related to feedback and decision making.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501423000283/pdfft?md5=3ff7483483accbec05e424bfffffa776&pid=1-s2.0-S2772501423000283-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138738662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding informed consent and publication ethics statements in previously published articles in Human Factors in Healthcare [Volumes 1 – 4]","authors":"","doi":"10.1016/j.hfh.2024.100067","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100067","url":null,"abstract":"","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100067"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000046/pdfft?md5=f123bb183bbcf0530f59eb7cb1edc56c&pid=1-s2.0-S2772501424000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139936222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pre-anesthesia induction patient safety (PIPS) checklist: Testing dynamic versus static implementation strategies","authors":"Thomas D. Looke ,&nbsp;Shirley C. Sonesh ,&nbsp;Ashley M. Hughes ,&nbsp;Megan E. Gregory ,&nbsp;Julie Pepe ,&nbsp;Nicole C. Hammer ,&nbsp;Eduardo Salas","doi":"10.1016/j.hfh.2023.100060","DOIUrl":"10.1016/j.hfh.2023.100060","url":null,"abstract":"<div><h3>Background</h3><p>Retrospective studies and large-scale reviews suggest multiple properties of effective checklist implementation, such as active leadership, ongoing feedback, and local modification. We hypothesized that the use of these effective checklist implementation strategies would yield better results as compared to a more fixed implementation strategy of the Pre-anesthesia Induction Patient Safety (PIPS) checklist.</p></div><div><h3>Methods</h3><p>We conducted a prospective, pre-post, pragmatic cohort trial of a checklist implementation using a prospective difference-in-difference design observing simultaneous implementation of the same PIPS checklist in two community hospitals. At one hospital, we created a multidisciplinary committee of stakeholders to oversee implementation and provide active leadership, ongoing feedback, and local modification of the checklist (“Dynamic Implementation”). At the second hospital, a single clinical champion implemented the checklist with no local modification (“Static Implementation”). We examined checklist compliance and proximal outcomes three months before and nine months after implementation. We conducted surveys and interviews to examine attitudes and implementation barriers.</p></div><div><h3>Results</h3><p>We observed 477 anesthesia inductions. The “Dynamic” cohort demonstrated significantly greater checklist compliance post-implementation compared to the “Static” cohort (<em>B</em> = 0.26, <em>p</em> &lt; .001 for observable action and <em>B</em> = 0.24, <em>p</em> &lt; .001 for verbal compliance). We were underpowered to detect changes in errors, or near-misses, but observers captured anecdotal checklist-related patient safety evidence, suggesting more research should be done in this area. There were no differences between cohorts on changes in team communication, or attitudes toward checklists. Participant interviews showed that two of the major criticisms of the PIPS checklist, ambiguity and redundancy, were more effectively resolved with the “Dynamic” implementation.</p></div><div><h3>Conclusions</h3><p>Dynamic implementation yielded significantly better compliance with the checklist than a more static approach. However, barriers such as time pressure and lack of team buy-in remain. Larger scale studies are needed to determine the full impact of the PIPS checklist on safety related outcomes such as near-misses.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100060"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501423000271/pdfft?md5=177f12745a73047ea8135f571e242077&pid=1-s2.0-S2772501423000271-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding informed consent and publication ethics statements in previously published articles in Human Factors in Healthcare","authors":"","doi":"10.1016/j.hfh.2024.100064","DOIUrl":"https://doi.org/10.1016/j.hfh.2024.100064","url":null,"abstract":"","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"5 ","pages":"Article 100064"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501424000010/pdfft?md5=9a7cf8442e7548550ddc16b4b136f046&pid=1-s2.0-S2772501424000010-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139487697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}