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Alqarrain Y, Roudsari A, Courtney KL, Tanaka J. Improving Situation Awareness to Advance Patient Outcomes: A Systematic Literature Review. Comput Inform Nurs 2024; 42:277-288. [PMID: 38376409 DOI: 10.1097/cin.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
Improving nurses' situation awareness skills would likely improve patient status recognition and prevent adverse events. Technologies such as electronic health record dashboards can be a promising approach to support nurses' situation awareness. However, the effect of these dashboards on this skill is unknown. This systematic literature review explores the evidence around interventions to improve nurses' situation awareness at the point of care. Current research on this subject is limited. Studies that examined the use of electronic health record dashboards as an intervention had weak evidence to support their effectiveness. Other interventions, including communication interventions and structured nursing assessments, may also improve situation awareness, but more research is needed to confirm this. It is important to carefully consider the design and content of situation awareness interventions, as well as the specific outcomes being measured, when designing situation awareness interventions. Overall, there is a need for higher-quality research in this area to determine the most effective interventions for improving nurse situation awareness. Future studies should focus on developing dashboards that follow a theoretical situation awareness model information and represent all situation awareness levels.
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Affiliation(s)
- Yaser Alqarrain
- Author Affiliations: University of Victoria Faculty of Human & Social Development, British Columbia, Canada
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2
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Shoemaker MJ, Collins SM. From the Flight Deck to the Bedside: Core Aviation Concepts Applied to Acute Care Physical Therapist Practice and Education. Phys Ther 2023; 103:pzad125. [PMID: 37712880 DOI: 10.1093/ptj/pzad125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 06/21/2023] [Accepted: 07/24/2023] [Indexed: 09/16/2023]
Abstract
The health care industry has sought to reduce errors and patient harm by drawing upon human factors research developed largely in the aviation industry. However, literature that explicitly applies human factors concepts to physical therapist practice is scarce. Therefore, this clinical perspective highlights the key concepts in aviation safety and training that should be considered for application to physical therapist education and practice in the acute care setting, including the law of primacy, pilot in command, crew resource management, situational awareness, the instrument scan, currency versus proficiency, the advanced qualification program, and the use of checklists. The authors identify, discuss, and apply existing parallel concepts in physical therapist literature. The authors then challenge acute care physical therapists, academic faculty, and clinical instructors on ways to integrate these concepts in practice.
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Affiliation(s)
- Michael J Shoemaker
- Department of Physical Therapy and Athletic Training, Grand Valley State University, Grand Rapids, Michigan, USA
| | - Sean M Collins
- Department of Physical Therapy, Plymouth State University, Plymouth, New Hampshire, USA
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Bhatia MR, Malhotra A, Bansal U, Singh JV, Kumar A. Using the Endsley Model to Evaluate Simulation-Based Situation Awareness Training for Medical and Nursing Students in India: A Qualitative Analysis. Simul Healthc 2023; 18:247-254. [PMID: 35921613 DOI: 10.1097/sih.0000000000000677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Situation awareness (SA) training is a vital part of healthcare training, and opportunities to provide SA training to healthcare workers are limited in low- and middle-income countries. We aimed to analyze undergraduate medical and nursing students' perception of their understanding of SA through an interprofessional obstetric neonatal emergency simulation workshop (ONE-Sim) and subsequently evaluate their perceived changes in SA understanding using the Endsley model ( Hum Factors 1995;37(1):32-64). METHODS Feedback on SA before and after the workshop was collected through questionnaire-based surveys. Thematic analysis was performed, with themes emerging from an inductive analysis followed by a deductive analysis using the Endsley model. RESULTS The themes emerging from the inductive analysis included environmental awareness, evolving knowledge, skill development, and applicability to practice. These aligned with the 3 levels of SA in the Endsley model in the deductive analysis suggesting that participants transformed their perception, comprehension, and projection of SA after the workshop. CONCLUSION Simulation-based education enhanced SA perception in obstetric and neonatal emergencies for medical and nursing students in a low- and middle-income country, and the Endsley model is a feasible framework to measure learner perceived changes in SA understanding through simulation-based education.
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Affiliation(s)
- Manini R Bhatia
- From the Royal Children's Hospital (M.R.B.); Department of Paediatrics (A.M.), Monash University, Melbourne, Australia; Hind Institute of Medical Sciences (A.M., U.B., J.V.S., A.K.); Lucknow, India; and Department of Obstetrics and Gynaecology (A.K.), Monash University, Melbourne, Australia
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Mastrianni A, Sarcevic A, Hu A, Almengor L, Tempel P, Gao S, Burd RS. Transitioning Cognitive Aids into Decision Support Platforms: Requirements and Design Guidelines. ACM TRANSACTIONS ON COMPUTER-HUMAN INTERACTION : A PUBLICATION OF THE ASSOCIATION FOR COMPUTING MACHINERY 2023; 30:41. [PMID: 37694216 PMCID: PMC10489246 DOI: 10.1145/3582431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 12/16/2022] [Indexed: 09/12/2023]
Abstract
Digital cognitive aids have the potential to serve as clinical decision support platforms, triggering alerts about process delays and recommending interventions. In this mixed-methods study, we examined how a digital checklist for pediatric trauma resuscitation could trigger decision support alerts and recommendations. We identified two criteria that cognitive aids must satisfy to support these alerts: (1) context information must be entered in a timely, accurate, and standardized manner, and (2) task status must be accurately documented. Using co-design sessions and near-live simulations, we created two checklist features to satisfy these criteria: a form for entering the pre-hospital information and a progress slider for documenting the progression of a multi-step task. We evaluated these two features in the wild, contributing guidelines for designing these features on cognitive aids to support alerts and recommendations in time- and safety-critical scenarios.
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Affiliation(s)
- Angela Mastrianni
- College of Computing and Informatics, Drexel University, Philadelphia, USA
| | | | - Allison Hu
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C., USA
| | - Lynn Almengor
- College of Computing and Informatics, Drexel University, Philadelphia, USA
| | - Peyton Tempel
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C., USA
| | - Sarah Gao
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C., USA
| | - Randall S Burd
- Division of Trauma and Burn Surgery, Children's National Hospital, Washington, D.C., USA
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Zestic J, Liley HG, Sanderson PM. Similarity of expert clinicians’ rank order of differential diagnoses in a newborn resuscitation context. Resusc Plus 2022; 11:100263. [PMID: 35812718 PMCID: PMC9256641 DOI: 10.1016/j.resplu.2022.100263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/01/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Jelena Zestic
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Corresponding author at: School of Psychology, The University of Queensland, St Lucia, QLD 4072, Australia.
| | - Helen G. Liley
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Mater Mothers’ Hospital and Mater Research Institute, Brisbane, Queensland, Australia
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Hoonakker PLT, Hose BZ, Carayon P, Eithun BL, Rusy DA, Ross JC, Kohler JE, Dean SM, Brazelton TB, Kelly MM. Scenario-Based Evaluation of Team Health Information Technology to Support Pediatric Trauma Care Transitions. Appl Clin Inform 2022; 13:218-229. [PMID: 35139563 PMCID: PMC8828456 DOI: 10.1055/s-0042-1742368] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/21/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Clinicians need health information technology (IT) that better supports their work. Currently, most health IT is designed to support individuals; however, more and more often, clinicians work in cross-functional teams. Trauma is one of the leading preventable causes of children's death. Trauma care by its very nature is team based but due to the emergent nature of trauma, critical clinical information is often missed in the transition of these patients from one service or unit to another. Teamwork transition technology can help support these transitions and minimize information loss while enhancing information gathering and storage. In this study, we created a large screen technology to support shared situational awareness across multiple clinical roles and departments. OBJECTIVES This study aimed to examine if the Teamwork Transition Technology (T3) supports teams and team cognition. METHODS We used a scenario-based mock-up methodology with 36 clinicians and staff from the different units and departments who are involved in pediatric trauma to examine T3. RESULTS Results of the evaluation show that most participants agreed that the technology helps achieve the goals set out in the design phase. Respondents thought that T3 organizes and presents information in a different way that was helpful to them. CONCLUSION In this study, we examined a health IT (T3) that was designed to support teams and team cognition. The results of our evaluation show that participants agreed that T3 does support them in their work and increases their situation awareness.
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Affiliation(s)
- Peter L. T. Hoonakker
- Wisconsin Institute for Health Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Bat-Zion Hose
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Perelman School of Medicine, Philadelphia, United States
| | - Pascale Carayon
- Wisconsin Institute for Health Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States
| | - Ben L. Eithun
- American Family Children's Hospital, Madison, Wisconsin, United States
| | - Deborah A. Rusy
- Department of Anesthesiology, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, United States
| | - Joshua C. Ross
- Department of Emergency Medicine, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, United States
| | - Jonathan E. Kohler
- Department of Surgery, UC Davis Children's Hospital, Sacramento, California, United States
| | - Shannon M. Dean
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, United States
| | - Tom B. Brazelton
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, United States
| | - Michelle M. Kelly
- Department of Pediatrics, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, United States
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Zestic J, Liley H, Sanderson P. Concordance of expert clinicians' interpretations of the newborn's true physiological state. Pediatr Res 2022; 91:1222-1230. [PMID: 34183769 PMCID: PMC8236569 DOI: 10.1038/s41390-021-01565-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/23/2021] [Accepted: 04/26/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Many physiological aspects of the neonatal transition after birth are unobservable because relevant sensors do not yet exist, compromising clinicians' understanding of a neonate's physiological status. Given that a neonate's true physiological state is currently unavailable, we explored the feasibility of using clinicians' degree of concordance as an approximation of the true physiological state. METHODS Two phases of structured interviews were conducted. In Phase 1 (N = 8) and Phase 2 (N = 12), we presented neonatal experts with eight graphical trajectories of real newborns' heart rate and oxygen saturation values in the first 10-15 min after birth. We elicited the participants' interpretations of potential underlying physiological conditions that could explain the vital sign patterns. RESULTS The global differential diagnosis data for each phase produced the same pattern of results: (1) four trajectories produced a substantial degree of concordance among clinicians (61-80%) and (2) four trajectories produced a strong degree of concordance among clinicians (81-100%). CONCLUSIONS It is possible to achieve a strong degree of concordance among neonatal experts' interpretations of newborn trajectories. Thus, using the degree of concordance as an approximation of the neonate's true physiological state in resuscitation after birth may be a promising direction to explore for cognitive aid design. IMPACT Differential diagnoses with a good degree of concordance among expert neonatal clinicians could potentially substitute in part for the direct measurement of key physiological and anatomical variables of the neonatal transition, which is currently unavailable. The concordance of clinicians' judgements or inferences with regards to the true physiological state of the newborn during resuscitation after birth has never been explored. The findings provide a crucial first step toward using consensus of neonatal experts' judgements in the design of a cognitive aid to support clinicians' management of the newborns who require resuscitation after birth.
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Affiliation(s)
- Jelena Zestic
- The University of Queensland, St Lucia, QLD, Australia.
| | - Helen Liley
- grid.1003.20000 0000 9320 7537The University of Queensland, St Lucia, QLD Australia ,grid.416563.30000 0004 0642 1922Mater Mothers’ Hospital and Mater Research Institute, Brisbane, QLD Australia
| | - Penelope Sanderson
- grid.1003.20000 0000 9320 7537The University of Queensland, St Lucia, QLD Australia
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Walshe N, Ryng S, Drennan J, O'Connor P, O'Brien S, Crowley C, Hegarty J. Situation awareness and the mitigation of risk associated with patient deterioration: A meta-narrative review of theories and models and their relevance to nursing practice. Int J Nurs Stud 2021; 124:104086. [PMID: 34601204 DOI: 10.1016/j.ijnurstu.2021.104086] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/27/2021] [Accepted: 08/31/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Accurate situation awareness has been identified as a critical component of effective deteriorating patient response systems and an essential patient safety skill for nursing practice. However, situation awareness has been defined and theorised from multiple perspectives to explain how individuals, teams and systems maintain awareness in dynamic task environments. AIM Our aim was to critically analyse the different approaches taken to the study of situation awareness in healthcare and explore the implications for nursing practice and research as it relates to clinical deterioration in ward contexts. METHODS We undertook a meta-narrative review of the healthcare literature to capture how situation awareness has been defined, theorised and studied in healthcare. Following an initial scoping review, we conducted an extensive search of ten electronic databases and included any theoretical, empirical or critical papers with a primary focus on situation awareness in an inpatient hospital setting. Included papers were collaboratively categorised in accordance with their theoretical framing, research tradition and paradigm with a narrative review presented. RESULTS A total of 120 papers were included in this review. Three overarching narratives reflecting philosophical, patient safety and solution focussed framings of situation awareness and seven meta-narratives were identified as follows: individual, team and systems perspectives of situation awareness (meta-narratives 1-3), situation awareness and patient safety (meta-narrative 4), communication tools, technologies and education to support situation awareness (meta-narratives 5-7). We identified a concentration of literature from anaesthesia and operating rooms and a body of research largely located within a cognitive engineering tradition and a positivist research paradigm. Endsley's situation awareness model was applied in over 80% of the papers reviewed. A minority of papers drew on alternative situation awareness theories including constructivist, collaborative and distributed perspectives. CONCLUSIONS Nurses have a critical role in identifying and escalating the care of deteriorating patients. There is a need to build on prior studies and reflect on the reality of nurse's work and the constraints imposed on situation awareness by the demands of busy inpatient wards. We suggest that this will require an analysis that complements but goes beyond the dominant cognitive engineering tradition to reflect the complex socio-cultural reality of ward-based teams and to explore how situation awareness emerges in increasingly complex, technologically enabled distributed healthcare systems.
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Affiliation(s)
- Nuala Walshe
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland.
| | - Stephanie Ryng
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland
| | - Jonathan Drennan
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland.
| | - Paul O'Connor
- Department of General Practice, National University of Ireland, Distillery Road, Newcastle, Co Galway H91 TK33, Ireland.
| | - Sinéad O'Brien
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland.
| | - Clare Crowley
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland.
| | - Josephine Hegarty
- School of Nursing and Midwifery, University College Cork, College Road, Cork T12 AK54, Ireland.
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Dewolf P, Clarebout G, Wauters L, Van Kerkhoven J, Verelst S. The Effect of Teaching Nontechnical Skills in Advanced Life Support: A Systematic Review. AEM EDUCATION AND TRAINING 2021; 5:e10522. [PMID: 34041431 PMCID: PMC8138104 DOI: 10.1002/aet2.10522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/14/2020] [Accepted: 08/17/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the effect of nontechnical skills (NTS) training on performance in advanced life support (ALS) simulation. Furthermore, we aimed to determine the ideal frequency of training sessions for an optimal retention and the value of debriefing. METHODS A systematic search was performed using PubMed, EMBASE, WoS, ERIC, CINAHL, and the Cochrane Library conducted through August 1, 2018. All primary studies mentioning NTS in ALS education were included. Three reviewers independently extracted data on study design and outcome. The MERSQI approach was used to evaluate the overall quality of evidence. RESULTS Of the 10,723 identified articles, 40 studies were included with a combined total of 3,041 participants, ranging from students to experts. Depending on the focus of the study, articles were categorized in NTS (n = 25), retention (n = 8), and feedback (n = 10). Incorporating NTS during ALS simulation showed significant improvements in timing for performing critical first steps. Furthermore, good leadership skills had a favorable effect on overall technical performance and teamwork during simulation improved team dynamics and performance. Finally, debriefing also had a beneficial effect on team performance. One particular type of debriefing does not appear to be superior to other types of debriefing. CONCLUSION Team simulation training resulted in improved NTS and a reduction in the time required to complete a simulated cardiac arrest. Therefore, a formal NTS program should be introduced into ALS courses. Feedback and repetitive practice are key factors to train NTS. The impact of training on team behaviors can persist for at least 3 to 6 months. In conclusion, understanding and improving NTS may help to create more effective teams. The effect on patient outcome requires further investigation.
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Affiliation(s)
- Philippe Dewolf
- Department of Emergency MedicineUniversity Hospitals LeuvenLeuvenFlandersBelgium
- Faculty of MedicineKU LeuvenLeuvenFlandersBelgium
| | - Geraldine Clarebout
- Faculty of Psychology and Pedagogical SciencesCentre for Instructional Psychology and TechnologyKU LeuvenLeuvenFlandersBelgium
| | - Lina Wauters
- Department of Emergency MedicineUniversity Hospitals LeuvenLeuvenFlandersBelgium
| | - Joke Van Kerkhoven
- Department of Emergency MedicineUniversity Hospitals LeuvenLeuvenFlandersBelgium
| | - Sandra Verelst
- Department of Emergency MedicineUniversity Hospitals LeuvenLeuvenFlandersBelgium
- Faculty of MedicineKU LeuvenLeuvenFlandersBelgium
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Verbeek-van Noord I, Smits M, Zwijnenberg NC, Spreeuwenberg P, Wagner C. A nation-wide transition in patient safety culture: a multilevel analysis on two cross-sectional surveys. Int J Qual Health Care 2020; 31:627-632. [PMID: 30395225 DOI: 10.1093/intqhc/mzy228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/02/2018] [Accepted: 10/18/2018] [Indexed: 12/11/2022] Open
Abstract
QUALITY PROBLEM OR ISSUE Patient safety is an important topic within healthcare systems. A favourable safety culture might promote safety. We examined whether a nation-wide patient safety programme (PSP) improved patient safety culture. INITIAL ASSESSMENT We initially measured patient safety culture among 3779 healthcare providers in 45 hospitals in the Netherlands, using the Hospital Survey on Patient Safety Culture. CHOICE OF SOLUTION A PSP based on two pillars: the implementation of a safety management system and the focus on 10 themes in which harm to patients appeared highly preventable. Elements of the safety management system were safety management, safety culture, risk assessments and continuous safety improvements. IMPLEMENTATION Implementation was nation-wide. EVALUATION After implementation of the programme, we assessed patient safety culture among 6605 healthcare providers in 24 Dutch hospitals and compared the scores with the initial measurement. We hypothesized that after the programme (1) scores on safety culture dimensions improved, (2) safety culture became more homogeneous within and between hospitals and (3) relative influence of hospitals on safety culture increased. A three-level mixed model for continuous responses was fit for 11 safety culture dimensions. We calculated average individual means, between-department variances, between-hospital variances and total variances per dimension. LESSONS LEARNED In general, a more favourable safety culture was seen after the PSP. However, hospitals and departments did not become more homogeneous, except for 'frequency of event reporting'. The variety in responses amongst departments and hospitals increased for several dimensions, implying that not all of them improved.
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Affiliation(s)
- I Verbeek-van Noord
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, BT Amsterdam, the Netherlands
| | - M Smits
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118-124, CR Utrecht, the Netherlands
| | - N C Zwijnenberg
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118-124, CR Utrecht, the Netherlands
| | - P Spreeuwenberg
- Nivel, Netherlands Institute for Health Services Research, Otterstraat 118-124, CR Utrecht, the Netherlands
| | - C Wagner
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, BT Amsterdam, the Netherlands.,Nivel, Netherlands Institute for Health Services Research, Otterstraat 118-124, CR Utrecht, the Netherlands
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Defining information needs in neonatal resuscitation with work domain analysis. J Clin Monit Comput 2020; 35:689-710. [PMID: 32458169 DOI: 10.1007/s10877-020-00526-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 05/07/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To gain a deeper understanding of the information requirements of clinicians conducting neonatal resuscitation in the first 10 min after birth. BACKGROUND During the resuscitation of a newborn infant in the first minutes after birth, clinicians must monitor crucial physiological adjustments that are relatively unobservable, unpredictable, and highly variable. Clinicians' access to information regarding the physiological status of the infant is also crucial to determining which interventions are most appropriate. To design displays to support clinicians during newborn resuscitation, we must first carefully consider the information requirements. METHODS We conducted a work domain analysis (WDA) for the neonatal transition in the first 10 min after birth. We split the work domain into two 'subdomains'; the physiology of the neonatal transition, and the clinical resources supporting the neonatal transition. A WDA can reveal information requirements that are not yet supported by resources. RESULTS The physiological WDA acted as a conceptual tool to model the exact processes and functions that clinicians must monitor and potentially support during the neonatal transition. Importantly, the clinical resources WDA revealed several capabilities and limitations of the physical objects in the work domain-ultimately revealing which physiological functions currently have no existing sensor to provide clinicians with information regarding their status. CONCLUSION We propose two potential approaches to improving the clinician's information environment: (1) developing new sensors for the information we lack, and (2) employing principles of ecological interface design to present currently available information to the clinician in a more effective way.
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Łoś K, Chmielewski J, Łuczyński W. Relationship between Executive Functions, Mindfulness, Stress, and Performance in Pediatric Emergency Simulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062040. [PMID: 32204436 PMCID: PMC7142723 DOI: 10.3390/ijerph17062040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/14/2020] [Accepted: 03/17/2020] [Indexed: 12/30/2022]
Abstract
Over the past decade, high-fidelity medical simulation has become an accepted and widely used teaching method in pediatrics. Both simulation and work in the real conditions of emergency departments are accompanied by stress that affects the executive functions of participants. One of the methods for reducing stress among medical students and healthcare professionals is the practice of mindfulness. The aim of this study was to examine whether executive functions, mindfulness, and stress are related to the technical and non-technical skills of medical students participating in medical simulations in pediatrics. The study included 153 final-year medical students. A total of 306 high-fidelity simulations of life-threatening situations involving children were conducted. Results: Stress and the coping mechanism of the participants were correlated to their skills during pediatric simulations. Some components of mindfulness, such as non-judgment and conscious action, were positively related to the skills of medical team leaders. Executive functions correlated with the non-technical skills and mindfulness of the medical students. Conclusions: Stress, mindfulness, and executive functions modeled the behavior and skills of medical students during pediatric simulations of life-threatening events. Further research in this area may prove whether mindfulness training will improve learning outcomes in pediatric emergency medicine.
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Carayon P, Hoonakker P. Human Factors and Usability for Health Information Technology: Old and New Challenges. Yearb Med Inform 2019; 28:71-77. [PMID: 31419818 PMCID: PMC6697515 DOI: 10.1055/s-0039-1677907] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Despite national mandates, incentives, and other programs, the design of health information technology (IT) remains problematic and usability problems continue to be reported. This paper reviews recent literature on human factors and usability of health IT, with a specific focus on research aimed at applying human factors methods and principles to improve the actual design of health IT, its use, and associated patient and clinician outcomes. METHODS We reviewed recent literature on human factors and usability problems of health IT and research on human-centered design of health IT for clinicians and patients. RESULTS Studies continue to show usability problems of health IT experienced by multiple groups of health care professionals (e.g., physicians and nurses) as well as patients. Recent research shows that usability is influenced by both designers (e.g., IT vendors) and implementers in health care organizations, and that the application of human-centered design practices needs to be further improved and extended. We welcome emerging research on the design of health IT for teams as team-based care is increasingly implemented throughout health care. CONCLUSIONS Progress in the application of human factors methods and principles to the design of health IT is occurring, with important information provided on their actual impact on care processes and patient outcomes. Future research should examine the work of health IT designers and implementers, which would help to develop strategies for further embedding human factors engineering in IT design processes.
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Affiliation(s)
- Pascale Carayon
- Department of Industrial and Systems Engineering, Wisconsin Institute for Healthcare Systems Engineering, University of Wisconsin-Madison, Madison, USA
| | - Peter Hoonakker
- Department of Industrial and Systems Engineering, Wisconsin Institute for Healthcare Systems Engineering, University of Wisconsin-Madison, Madison, USA
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Fencl JL, Willoughby C. Daily Organizational Safety Huddles: An Important Pause for Situational Awareness. AORN J 2018; 109:111-118. [DOI: 10.1002/aorn.12571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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