Gaze Performance Adjustment During Needlestick Application: Can We Reduce Harm?

Eye-tracking analysis for situation awareness of incontinence pad changing during older adult nursing training: An observational study

AIM

This study aims to investigate eye tracking in the practical training of incontinence pad change, which is commonly required in older adult nursing.

BACKGROUND

Some competencies possessed by skilled and experienced personnel are difficult to verbalize into textbooks. However, this is crucial for education, especially nursing practice education. Eye-gaze analysis is one such tool that can aid the efficient transfer of knowledge to students. Therefore, eye-gaze analysis, a novel technology for visualizing situational awareness and decision-making, has recently gained traction in healthcare.

DESIGN

An observation study METHODS: Ten nursing faculty members and 13 nursing students with prior incontinence pad change experience participated in this study using an older adult simulator. There were two groups of students - S1 with more recent experience in older adult care and incontinence pad changing and S2 with less. Areas of interest (AOIs) during incontinence pad preparation and fitting were determined based on gaze fixation and the time spent fixating on these areas was compared.

RESULTS

Students took longer than nursing faculty members. When visualizing the eye movements between the AOIs in the network, the faculty nurses and S1 alternated their gaze between the new incontinence pad and the buttocks and between other AOIs. Simultaneously, S2 tended to gaze or stare only at the new incontinence pad.

CONCLUSION

The presented data may help interpret visual-based situational awareness and establish effective nursing education, especially in acquiring skills that are difficult to verbalize.

Application of eye-tracking in nursing research: A scoping review

AIMS

To map the themes and methods of nursing researches involving eye-tracking as a measurement, and offer suggestion for future nursing research using eye-tracking.

DESIGN

We conducted a scoping review following the methodology outlined in the JBI Manual for Evidence Synthesis on scoping reviews.

METHODS

Eligibility criteria were established based on Population (involving nursing or nursing students), Concept (utilizing eye-tracking as a research method), and Context (in any setting). Articles were retrieved from the PubMed, Web of Science, Embase, CINAHL, APA PsycInfo, and Scopus databases, spanning from database inception to November 17, 2023. The included studies were analysed using descriptive statistics and content analysis.

RESULTS

After duplicates were removed, 815 citations were identified from searches of electronic databases and other resources, and 66 met the inclusion criteria finally. Thirty-eight studies were conducted in a simulated environment. Five application domains were identified, and most of the studies (N = 50) were observational. The domains found in our review did not cover all topics of nursing research in the same depth. Additionally, 39 studies did not solely explicate eye-tracking data but instead integrated behavioural measures, scales/questionnaires, or other physiological data.

CONCLUSIONS

Eye-tracking emerges as a significant research tool in uncovering visual behaviour, particularly in nursing research focused on nursing education. This study not only summarized the application and interpretation of eye-tracking data but also recognized its potential in advancing clinical nursing research and practice. To effectively harness the capabilities of eye-tracking in elucidating cognitive processes, future research should aim for a clearer grasp of the theoretical underpinnings of the addressed research problems and methodological choices. It is crucial to emphasize the standardization of eye-tracking method reporting and ensuring data quality. No Patient or Public Contribution.

Assessing the Link between Nurses' Proficiency and Situational Awareness in Neonatal Care Practice Using an Eye Tracker: An Observational Study Using a Simulator

Nurses are expected to depend on a wide variety of visually available pieces of patient information to understand situations. Thus, we assumed a relationship between nurses' skills and their gaze trajectories. An observational study using a simulator was conducted to analyze gaze during neonatal care practice using eye tracking. We defined the face, thorax, and abdomen of the neonate, the timer, and the pulse oximeter as areas of interest (AOIs). We compared the eye trajectories for respiration and heart rate assessment between 7 experienced and 13 novice nurses. There were no statistically significant differences in the time spent on each AOI for breathing or heart rate confirmation. However, in novice nurses, we observed a significantly higher number of instances of gazing at the thorax and abdomen. The deviation in the number of instances of gazing at the face was also significantly higher among novice nurses. These results indicate that experienced and novice nurses differ in their gaze movements during situational awareness. These objective and quantitative differences in gaze trajectories may help to establish new educational tools for less experienced nurses.

Factors behind why nursing students do not recognize patient needs occurring while confirming intravenous infusion even when they observe them: A comparative descriptive design study

BACKGROUND

Novice nurses are often unable to watch their surroundings closely when concentrating on their work or recognize them even when observing them closely. However, factors behind this have not been previously explored.

OBJECTIVES

The purpose of this study was to clarify why nursing students did not recognize the patient's needs while checking an infusion.

DESIGN

A comparative, descriptive design study.

SETTINGS

The mock hospital room was set up in a training room of the School of Nursing, University A using partitions. The participants checked an infusion under experimental conditions, and we confirmed whether they recognized the patient's needs, which were signs of discomfort such as "uncomfortable posture," "disheveled pajamas," and "creased sheets."

PARTICIPANTS

A total of 43 students participated, including second- and third-year students of the School of Nursing, University A.

METHODS

The subjects confirmed in an interview whether they had recognized the needs. Their observational behaviors toward the patient and surroundings were measured with an eye mark recorder. Working memory capacity and mental load were measured with Japanese versions of Reading Span Test (RST) and NASA Task Load Index (NASA-TLX).

RESULTS

Seventeen students recognized the patient's needs. Twelve (70.6%) recognized them when entering the room, with no significant differences in their watching behaviors between the Cognitive and Non-cognitive Groups. RST results were significantly high in Non-cognitive Group (P < .02), and only temporal demand among the sub-items of NASA-TLX presented high.

CONCLUSIONS

The nursing students who did not recognize the patient's needs while checking an infusion were watching the patient in the same way as the students who did recognize the patient's needs. We presumed that the factors for being unable to recognize were an over-focus on checking on infusion and time pressure.

Needlestick injuries: the role of safety-engineered devices in prevention

The first documented mention of a needlestick injury (NSI) in the medical literature appeared in 1906. Despite growth in academic and clinical interest for NSI prevention, a global report identified that approximately 3 million healthcare workers have suffered percutaneous exposure to blood-borne pathogens. Legislation is an important component of NSI prevention. Unfortunately, the impact of legislation may not always reduce the incidence of NSI as much as expected. Safety-engineered device (SED) implementation has demonstrated a substantial reduction in NSI rates compared with non-SEDs. More importantly, passive SEDs are 10 times less likely to be connected with an NSI incident.