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Coldewey B, Diruf A, Röhrig R, Lipprandt M. Causes of use errors in ventilation devices - Systematic review. APPLIED ERGONOMICS 2022; 98:103544. [PMID: 34461508 DOI: 10.1016/j.apergo.2021.103544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 07/15/2021] [Accepted: 07/25/2021] [Indexed: 06/13/2023]
Abstract
A systematic review according to the PRISMA reporting standard was performed to identify causes of use errors in mechanical ventilators described in the literature. The PubMed search resulted in the inclusion of 16 papers. The errors described were systematically analyzed with regard to their causes and categorized in an adapted cause-and-effect diagram. The causes of use errors were related to specific usability issues and to the general condition that medical staff often work with different ventilators. When many devices are used, the different user interfaces are a source of use errors, since, for example, the same ventilation modes have different names. In order to avoid the identified causes for use errors in the future, this work offers manufacturers of ventilation devices design recommendations and the possibility to include the results in their risk management. In addition, standardizing user interface content across all ventilators, as in ISO 19223, can help reduce use errors.
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Affiliation(s)
- Beatrice Coldewey
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany.
| | - Annette Diruf
- Division for Medical Informatics, Faculty VI - Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26129 Oldenburg, Germany
| | - Rainer Röhrig
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; Division for Medical Informatics, Faculty VI - Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26129 Oldenburg, Germany
| | - Myriam Lipprandt
- Institute of Medical Informatics, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany; Division for Medical Informatics, Faculty VI - Medicine and Health Sciences, Carl von Ossietzky University of Oldenburg, 26129 Oldenburg, Germany
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Jiang M, Tu X, Xiao W, Tang J, Li Q, Sun D, Wang D. Usability testing of radiotherapy systems as a medical device evaluation tool to inform hospital procurement decision-making. Sci Prog 2021; 104:368504211036129. [PMID: 34372735 PMCID: PMC10450699 DOI: 10.1177/00368504211036129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Poor usability designs of radiotherapy systems can contribute to use errors and adverse events. Therefore, we evaluated the usability of two radiotherapy systems through radiation therapists' performance, workload, and experience that can inform hospital procurement decision-making about the selection of appropriate radiotherapy system for radiation therapist use. METHODS We performed a comparative usability study for two radiotherapy systems through user testing. Thirty radiation therapists participated in our study, in which four typical operational tasks were performed in two tested radiotherapy systems. User performance was measured by task completion time and completion difficulty level. User workloads were measured by perceived and physiological workload using NASA-TLX questionnaires and eye motion data. User experience was measured by the USE questionnaire. RESULTS Significantly less task completion time and an easier task completion difficulty level were shown with the Varian Trilogy than with the XHA600E. The study results suggest that higher perceived and physiological workloads were experienced with the XHA600E than with the Varian Trilogy. Radiation therapists reported better user experience with the Varian Trilogy than with the XHA600E. Five paired t-tests regarding user performance, user workload, and user experience between the Varian Trilogy and the XHA600E were performed, showing that the Varian Trilogy radiotherapy system has a better usability design than the XHA600E radiotherapy system. CONCLUSIONS Based on study results, we confirmed that the Varian Trilogy radiotherapy system has a better usability design than the XHA600E radiotherapy system. Furthermore, the study results provide valuable evidence for hospital procurement decision-making regarding the selection of a suitable radiotherapy system for radiation therapists to use.
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Affiliation(s)
- Mingyin Jiang
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuancheng Tu
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wanchao Xiao
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhui Tang
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Li
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongjie Sun
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Daoxiong Wang
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Hignett S, Edmonds J, Herlihey T, Pickup L, Bye R, Crumpton E, Sujan M, Ives F, Jenkins DP, Newbery M, Embrey D, Bowie P, Ramsden C, Rashid N, Williamson A, Bougeard AM, MacNaughton P. Human factors/ergonomics to support the design and testing of rapidly manufactured ventilators in the UK during the COVID-19 pandemic. Int J Qual Health Care 2021; 33:4-10. [PMID: 32780821 PMCID: PMC7454670 DOI: 10.1093/intqhc/mzaa089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 11/14/2022] Open
Abstract
Background This paper describes a rapid response project from the Chartered Institute of Ergonomics & Human Factors (CIEHF) to support the design, development, usability testing and operation of new ventilators as part of the UK response during the COVID-19 pandemic. Method A five-step approach was taken to (1) assess the COVID-19 situation and decide to formulate a response; (2) mobilise and coordinate Human Factors/Ergonomics (HFE) specialists; (3) ideate, with HFE specialists collaborating to identify, analyse the issues and opportunities, and develop strategies, plans and processes; (4) generate outputs and solutions; and (5) respond to the COVID-19 situation via targeted support and guidance. Results The response for the rapidly manufactured ventilator systems (RMVS) has been used to influence both strategy and practice to address concerns about changing safety standards and the detailed design procedure with RMVS manufacturers. Conclusion The documents are part of a wider collection of HFE advice which is available on the CIEHF COVID-19 website (https://covid19.ergonomics.org.uk/).
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Affiliation(s)
- Sue Hignett
- School of Design & Creative Arts, Loughborough University, Loughborough, LE11 3TU, UK
| | | | - Tracey Herlihey
- Healthcare Safety Investigation Branch, Farnborough, GU14 0LX, UK
| | - Laura Pickup
- Healthcare Safety Investigation Branch, Farnborough, GU14 0LX, UK
| | | | | | - Mark Sujan
- Human Factors Everywhere Ltd, Woking, GU21 2TJ, UK
| | - Fran Ives
- West Midlands Academic Health Science Network, Birmingham, B15 2TH, UK
| | | | | | - David Embrey
- Human Reliability Associates, Wigan, WN8 7RP, UK
| | - Paul Bowie
- NHS Education for Scotland, Glasgow, G3 8BW, UK
| | - Chris Ramsden
- The Chartered Society of Designers, London, SE1 3GA, UK
| | - Noorzaman Rashid
- Chartered Institute of Ergonomics & Human Factors, Stratford-upon-Avon, B95 6HJ, UK
| | - Alastair Williamson
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
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Jiang M, Sun D, Li Q, Wang D. The usability of ventilator maintenance user interface: A comparative evaluation of user task performance, workload, and user experience. Sci Prog 2020; 103:36850420962885. [PMID: 33138716 PMCID: PMC10450887 DOI: 10.1177/0036850420962885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Poor usability designed of ventilator user interface can easily lead to human error. In this study, we evaluated the usability design of ventilator maintenance user interface and identified problems related to the usability of user interface that could easily cause human error. Sixteen respiratory therapists participated in this usability study. The usability of the ventilator maintenance user interface was evaluated by participants' task performance (task completion time, task error rate), physiological workload (eye-fixation duration) and perceived workload (NASA-TLX), and user experience (questionnaire). For task performance, task completion time and task error rate showed significant differences. For task completion time, significant difference was found when conducting ventilator self-test (p < 0.001), replace the breathing circuit (p = 0.047), and check battery status (p = 0.005). For task error rate, the three ventilators showed significant difference (p = 0.012), and the Serov I showed a significantly higher task error rate than the Boaray 5000D (p = 0.031). For workload, the Serov I was associated with higher physiological and perceived workloads than other ventilators (p < 0.05). For user experience, the Boaray 5000D received better scores among the ventilators in terms of ease to maintain, friendly to maintain, and willingness to use (p < 0.05, respectively). Our study adds available literature for usability evaluation of ventilator maintenance user interface. The results indicate that the maintenance user interface of the Boaray 5000D performed better than the other two tested ventilators. Moreover, the study results also proved that eye-fixation duration can be a reliable tool for evaluating the usability of ventilator user interface.
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Affiliation(s)
- Mingyin Jiang
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongjie Sun
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Li
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Daoxiong Wang
- Department of Medical Equipment, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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