Human factors in healthcare最新文献

{"title":"Burnout among healthcare workers during public health emergencies in sub-Saharan Africa: Contributing factors, effects, and prevention measures","authors":"Enos Moyo ,&nbsp;Mathias Dzobo ,&nbsp;Perseverance Moyo ,&nbsp;Grant Murewanhema ,&nbsp;Itai Chitungo ,&nbsp;Tafadzwa Dzinamarira","doi":"10.1016/j.hfh.2023.100039","DOIUrl":"10.1016/j.hfh.2023.100039","url":null,"abstract":"<div><p>Countries in sub-Saharan Africa (SSA) are expected to experience more public health emergencies (PHEs) in the near future. The fragile health systems emanating from poor health governance, inadequate health infrastructure, shortage of healthcare workers (HCWs), inadequate essential medicines and technology, and limited funding will make responses to these outbreaks slow and ineffective as seen with the COVID-19 pandemic. The workload for HCWs will grow due to these PHEs, which will increase the likelihood that they may experience burnout. This narrative review loosely followed the guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement. Google Scholar, PubMed, and ScienceDirect databases were used to retrieve relevant articles. Two reviewers assessed the titles and abstracts of all identified articles and extracted the data independently and compared their results thereafter. The causes of burnout among HCWs, its impact on patients, HCWs, and healthcare institutions, as well as preventive steps that should be taken to safeguard HCWs from burnout, are all covered in this article.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100039"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47806946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An introduction to eye tracking in human factors healthcare research and medical device testing","authors":"Joseph R. Pauszek","doi":"10.1016/j.hfh.2022.100031","DOIUrl":"10.1016/j.hfh.2022.100031","url":null,"abstract":"<div><p>Eye tracking is a powerful and sophisticated tool that provides an objective glimpse into the cognition of healthcare providers, patients, caregivers, and medical device users. Insights gleaned from eye tracking can be harnessed to better understand – and ultimately improve – the dynamics of healthcare, which quite literally has the potential to save lives. Nonetheless, the use of eye tracking within healthcare research and medical device testing remains in its infancy, which at least partly reflects the learning curve that it demands. As such, the central aim of this article is to provide an easily digestible primer for healthcare researchers and practitioners interested in first getting started with eye tracking. The discussion offers a general overview of how it works, device types and notable specifications, a taxonomy of common metrics, and various sensible best practices and recommendations tailored to the use of wearable eye trackers in a high-fidelity simulated use study context.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100031"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44070590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma team on call: Why are we all so stressed?","authors":"Brandon T. Stryder ,&nbsp;Erin C. Hall ,&nbsp;Annemarie Newark ,&nbsp;Jack Sava ,&nbsp;Allan Fong ,&nbsp;Shimae C. Fitzgibbons","doi":"10.1016/j.hfh.2023.100035","DOIUrl":"10.1016/j.hfh.2023.100035","url":null,"abstract":"<div><h3>Background</h3><p>Acute stress is a known contributor to surgical outcomes. While trauma care is widely acknowledged to be stressful, understanding of specific sources of practitioner stress across learner levels is currently limited. Implementing tailored stress mitigation techniques is not possible without an increased understanding of the specific stress triggers. The objective of this study was to explore sources of acute stress for trauma care providers across various learner levels.</p></div><div><h3>Methods</h3><p>Semi-structured interviews were undertaken following major trauma activations at a Level 1 urban trauma center. Interviews were conducted with medical students, surgical residents, and surgical attendings, exploring their perception of acute stress during the preceding event. Interviews were transcribed, coded and analyzed for emerging themes.</p></div><div><h3>Results</h3><p>38 trauma team shifts were observed including major trauma activations. 58 interviews were conducted with 4 medical students, 7 junior residents, 4 senior residents, and 7 trauma surgery attendings. Three predominant themes related to sources of acute stress where identified: “performance”, “stress contagion” and “fear of the unknown”. While all three themes were identified across all learner levels, emphasis and context for a given theme varied based on an individual's position within the team hierarchy.</p></div><div><h3>Conclusions</h3><p>Three recurring sources of stress identified amongst all learner levels within the trauma team: “performance”, “stress contagion” and “fear of the unknown”. These themes offer concrete targets for future development of stress mitigation efforts.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"3 ","pages":"Article 100035"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43794168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum to ‘Prevalence, taxonomy, and outcomes of inpatient imaging incidental findings’ [Human Factors in Healthcare 3 (2023) 100037]","authors":"Preetha Nair ,&nbsp;Niraj Madhani ,&nbsp;Bryan Block ,&nbsp;Lindsay Ripley ,&nbsp;Maryam Warsi ,&nbsp;Anita Hegde ,&nbsp;Eugene S. Chu","doi":"10.1016/j.hfh.2023.100051","DOIUrl":"https://doi.org/10.1016/j.hfh.2023.100051","url":null,"abstract":"","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49720891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating operating room music volume with the CanaryBox: A quality improvement initiative to improve anesthesia clinicians’ response times to alarms to improve quality of anesthetic care","authors":"Akash K Gururaja ,&nbsp;Alexandra L Bruder ,&nbsp;Christy J Crockett ,&nbsp;Olivia P Henry ,&nbsp;Matthew S Shotwell ,&nbsp;Yaping Shi ,&nbsp;Joshua Shive ,&nbsp;Joseph J. Schlesinger","doi":"10.1016/j.hfh.2022.100029","DOIUrl":"10.1016/j.hfh.2022.100029","url":null,"abstract":"<div><p>Music is commonly played in the operating rooms and contributes to overall noise level. High noise levels in the operating room, often surpassing the National Institute for Occupational Safety and Health recommendations, affect clinician communication and vigilance. This study's primary aim was to reduce anesthesia provider response time to alarms to improve quality of care to patients undergoing general anesthesia. The aim of this quality improvement project was to reduce anesthesia provider response time to vital sign alarms with the tested intervention of the CanaryBox device to modulate music volume in the OR by August of 2021. Utilizing improvement science methods including the Model of Improvement and tested interventions via the Plan-Do-Study-Act cycles, we utilized the CanaryBox in the pediatric orthopedic operating rooms at Monroe Carell Jr. Children's Hospital at Vanderbilt. This device modulates music volume according to the severity of patient vital sign deviations. Timestamps of onset and response to patient vital sign alarms, recorded by the Philips IntelliVue Information Center system, were collected for 12 control (pre-intervention) and 58 intervention (with the CanaryBox) cases. Median and average response times were calculated for pre- and post-intervention cases. There was an associated decrease (improvement) in average anesthesia provider alarm response times from 30.2 seconds in pre-intervention cases to 23.6 seconds with CanaryBox intervention cases. Improved anesthesia provider response times with implementation of the CanaryBox imply less distraction due to unnecessary noise levels at critical periods. This improved vigilance and decreased response time indicate anesthesia providers deliver higher levels of patient care when the CanaryBox is modulating music volume.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100029"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000264/pdfft?md5=6a20fa203e5449e8fc78133ae87722f4&pid=1-s2.0-S2772501422000264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44576370","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":"Patient-centered magnetic-resonance imaging (MRI) procedures: HF/E design recommendations for experiential improvements","authors":"P.A. Hancock","doi":"10.1016/j.hfh.2022.100022","DOIUrl":"10.1016/j.hfh.2022.100022","url":null,"abstract":"","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100022"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000197/pdfft?md5=e71be5e9760df5543828388bfc424f56&pid=1-s2.0-S2772501422000197-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44947323","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":"When stirrups aren't available: Innovation of a low-cost pelvic lift cushion","authors":"Caroline Toney-Noland ,&nbsp;Peter Acker ,&nbsp;Kimber Padua ,&nbsp;Susan Crowe ,&nbsp;Lillian Sie ,&nbsp;Henry Lee","doi":"10.1016/j.hfh.2022.100020","DOIUrl":"10.1016/j.hfh.2022.100020","url":null,"abstract":"<div><h3>Introduction</h3><p>Gynecological exam beds with stirrups are considered by many the gold standard for patient positioning when performing a pelvic exam and suturing following a birth. However, there are many instances when a stirrup bed is not available due to the cost of the equipment, insufficient number of stirrup beds, or emergent procedures in centers that do not regularly stock such beds due to cost or lack of sufficient space. When a stirrup bed is not available, many clinicians resort to using work-arounds such as an upside-down bedpan or rolled towels to lift the patient's pelvis. While this may lift the patient's pelvis, this is uncomfortable for the patient and may even cause the patient to tense up during the medical procedure, making the exam or procedure harder to complete.</p></div><div><h3>Materials and Methods</h3><p>In 2018, a team at Stanford University developed a low-cost pelvic lift cushion as an alternative to upside-down bedpans that aimed improve patient comfort while maintaining satisfactory levels of visibility and physical access for clinicians. The Stanford team surveyed patient/clinician interactions in which the novel pelvic lift cushion, the stirrup bed, or an upside-down bedpan/rolled towels, were used.</p></div><div><h3>Results</h3><p>Based on 19 patient and clinician interactions, the pelvic lift cushion was found to provide patient comfort and appropriate access for clinicians during a pelvic exam. Clinicians scored it higher than the upside-down bedpan/rolled towels in every area.</p></div><div><h3>Conclusion</h3><p>This inexpensive innovation can improve patient comfort by using an appropriately designed device while maintaining clinician satisfaction in settings where gynecological stirrup beds are not available or desired. Further research is needed to determine the device's effectiveness for different procedures and with a more diverse sample size.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100020"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000173/pdfft?md5=86127033bc950176bdf40aadb277a98c&pid=1-s2.0-S2772501422000173-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42628829","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":"Prevalence of needlestick injuries and factors associated with their occurrence among health care workers at a private hospital in northern Namibia","authors":"Enos Moyo ,&nbsp;Tafadzwa Dzinamarira ,&nbsp;Malizgani Mhango ,&nbsp;Shingairai Feresu ,&nbsp;Perseverance Moyo","doi":"10.1016/j.hfh.2022.100028","DOIUrl":"10.1016/j.hfh.2022.100028","url":null,"abstract":"<div><h3>Background</h3><p>Although needle stick injuries (NSIs) are a very common preventable occupational hazard among healthcare workers (HCWs), their prevalence remains high. The study aimed to assess the prevalence of NSIs, and factors associated with NSIs among HCWs at a private hospital in northern Namibia. The HCWs included enrolled nurses, registered nurses, and doctors.</p></div><div><h3>Methods</h3><p>An analytic cross-sectional study design was used for the study. 400 respondents were selected using a proportional stratified random sampling method. A self-administered questionnaire designed for the study was used for data collection. Statistical analysis employed Chi-square tests and logistic regression.</p></div><div><h3>Results</h3><p>The 12 months prevalence rate of NSIs among HCWs was 37.5%, 95% CI (32.8% – 42.2%), while the career prevalence was 55.3%, 95% CI (50.4% – 60.2%). Most NSIs (30.3%) occurred in theatre, 40.3% were caused by syringe needles, 70.5% occurred on fingers, and 74.7% were of a prick nature. Chi-square tests showed an association between profession and NSIs and between work experience and NSIs (p&lt;0.01). Nurses were more likely to experience NSIs in the past 12 months compared to doctors, AOR = 4.31, 95% CI (1.50 – 12.38). Respondents with 2-5 years of work experience were less likely to experience NSIs in the past 12 months compared to those with less than two years of work experience, AOR = 0.36, 95% CI (0.21 – 0.62).</p></div><div><h3>Conclusion</h3><p>The findings of the study accentuate the need for hospital authorities to strengthen employees’ training on handling sharp instruments and support the use of instruments with safety features.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100028"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000252/pdfft?md5=538bf81093fe8fc20e6b71ea2de311d4&pid=1-s2.0-S2772501422000252-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48255030","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":"Ward rounds – A socio-technical system informed analysis of the perceptions of intern and senior house office doctors","authors":"E. Prescott ,&nbsp;A. Reynolds ,&nbsp;C. Kennedy ,&nbsp;B. Kennedy ,&nbsp;S. O'Callagan ,&nbsp;U. Geary ,&nbsp;D. Byrne ,&nbsp;E. Flynn ,&nbsp;Ó. Galvin ,&nbsp;H. Kielty ,&nbsp;G. Hughes ,&nbsp;M.E. Ward","doi":"10.1016/j.hfh.2022.100027","DOIUrl":"10.1016/j.hfh.2022.100027","url":null,"abstract":"<div><h3>Background</h3><p>Ward rounds (WRs) are a daily organisational process in hospitals. Studies have found variation however in the definition and objectives of WRs, where they take place, who partakes in them and how they impact patient care.</p></div><div><h3>Objectives</h3><p>This study was undertaken as part of a longitudinal improvement project in relation to WRs taking a socio-technical systems approach. The objective of this study was to explore junior doctors understanding of the goals, process sequence, social relations particularly understanding of roles and responsibilities, and information and knowledge in relation to WRs. We also wished to hear junior doctors’ perceptions of how WRs may be improved.</p></div><div><h3>Methods</h3><p>Our study took place in a large 1000 bed acute teaching hospital. A survey was developed by the improvement project team and administered to junior doctors at the hospital (n=148).</p></div><div><h3>Results</h3><p>A response rate of 30.4% was achieved (n=45 completing the survey). Junior doctors perceive the primary goals of WRs to be reviewing patient history and current status (39%) and progressing care plans (38%). They believe their main role on WRs to be writing notes (46.5%). 75% of participants reported that they fully understood their responsibilities on WR, while 67% fully understood the responsibilities of others. 80% reported learning on WRs lower than all other forms of learning.</p></div><div><h3>Conclusions</h3><p>The findings of this study will help inform our current ‘AS IS’ understanding of WR practice and co-design of improvements. We would argue that further systems level research is needed to examine the impact of lack of agreed goals; clarity in relation to roles and responsibilities; involvement of nursing and health and social care professionals in the WR, and perceived educational value of WRs on staff and patient outcomes.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100027"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000240/pdfft?md5=84776c82e13c29e7f08a2bb613f85aac&pid=1-s2.0-S2772501422000240-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42712061","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":"“One size” doesn't “fit all”: Understanding variability in anesthesia work practices","authors":"Joshua Biro ,&nbsp;David M. Neyens ,&nbsp;Candace Jaruzel ,&nbsp;Catherine D. Tobin ,&nbsp;Myrtede Alfred ,&nbsp;Sarah Coppola ,&nbsp;James H. Abernathy ,&nbsp;Ken R. Catchpole","doi":"10.1016/j.hfh.2022.100026","DOIUrl":"10.1016/j.hfh.2022.100026","url":null,"abstract":"<div><h3>Objectives</h3><p>This work examines the variability in how different anesthesia providers approach patient care to provide insight into the source and necessity of variations in practice, the implications of different individual preferences, and the subsequent consequences on approaches to safety that emphasize standardization.</p></div><div><h3>Methods</h3><p>Vignette-based interviews were performed with 18 anesthesia providers to elicit the cognitive processes and strategies that they utilize as they progress through a case. A qualitative data analysis of the transcripts was performed to illuminate the variability in their processes of managing the case.</p></div><div><h3>Results</h3><p>Participants employed converging strategies consistent with prior literature. However, divergence occurs in the application of those strategies; there is variability in participants’ information seeking strategies, problem anticipation, and resulting actions. In some instances, this divergence was minor, representing natural preferences that would inevitably converge in the management of the case. In other instances, this divergence represented major deviations that would not converge throughout the management of the case.</p></div><div><h3>Conclusions</h3><p>The differences in how anesthesia providers approach their work, as identified in this study, call into question whether ‘standardization’ is always the best approach to improve safety in anesthesia. Whatever the cause of variations in individual strategies, when developing new approaches, the variability in anesthesia information seeking, goal setting and anticipation needs to be reflected in policies, practices, protocols, and training. This work reinforces the idea that it is the humans in the system, with their flexibility and expertise, who are the primary source of everyday safety.</p></div>","PeriodicalId":93564,"journal":{"name":"Human factors in healthcare","volume":"2 ","pages":"Article 100026"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772501422000239/pdfft?md5=7d5380282c59f9fc07f2c01fc658dcab&pid=1-s2.0-S2772501422000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49058014","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}