Lecture 11 Human Factors In Healthcare 1 Flashcards
When it comes to the chain of victims who are effected by interruptions, what are they?
First victims (patients and families) Second victims (healthcare staff- not much support for people who make the mistake ) Third victims (organisations/cost etc)
What did Westbrook et al (2010) find when looking at nurses and their preparation and administration of medication ?
Westbrook et al counted the number of procedural failures and clinical errors nurses made when administering 4271 medications. They found a 12.1% increase in procedural errors and 12.7% of clinical errors per interruption.
Why don’t we just eliminate interruptions?
Current evidence is associative (don’t know if correlarional or causational)
Reducing or eliminating interruptions can have unintended consequences
Interruptions can be good
Interventions that don’t reduce interruptions…
Tomietto et al (2012) had nurses wear aprons that had do not disturb on them. But found that interruptions increased from other nurses and decreased from patients.
Interventions that do work when it comes to reducing interruptions…
Had nurses prepare and administer medication in a simulated healthcare environment. Ps made more medication errors when interruptions. So decreased the number of IV push errors by introducing the use of a timer.
What did Foroughi et al (2014,2015) find when it came to interruptions and essay writing?
Had ps write essays and do reading comprehension and introduced interruptions. Found that as interruptions increased the performance decreased. Most compelling evidence to date of causation between interruptions and performance.
Why did chiara and prof Penelope Sanderson do a pilot study to assess if interruptions cause more errors ?
A pilot study provides them with the needed statistical power for the hospital study.
It allows them to conduct different explorations.
Increases the prepardedness for the healthcare simulation.
Test robustness of hypotheses
Why don’t just go straight into hospital setting?
Needs large sample size
Frequent changes in ICU
Access to simulation room
Although the bar and hospital settings were similar in numerous ways, in what way could they argue to differ?
The amount of motivation to do well
What did the first experiment of the lab component of chiara and prof Penelope’s study address?
Used 10 ps who had more than 1 month bar experience and tested the number of baseline errors the bartenders made when making cocktails. Found that 44% of cocktails had at least 1 error. And there was considerable variability throughout.
What did the second experiment of the lab component look at in chiara and prof Penelope’s study ?
Used the finding from Westbrook et al (2010) study that clinical errors that nurses make increase by 12.7% per interruption to find that cohens d = 1.16 and would require 18 ps per condition. Then tested this where ps either had 1 or 4 interruptions throughout 3 scenarios to find that as interruptions increase, error making in cocktails also increased.
How common are interruptions in hospitals? How often do errors occur in tasks? And how many studies look at the effects of interruptions within healthcare ?
Very common approx 29-53% interruptions of clinical tasks has been reported. Errors occur in 26% of tasks. Less than 0.01% of studies address interruptions in healthcare.
How is cohens d and the required sample size for the healthcare component?
D = 0.79 N = 66 (33 per condition)
