RENAL - Clinical Reasoning and Human Factors Flashcards
Do near misses count as clinical errors?
YES
What are some common causes of clinical errors?
- Organisational failures
- Unsafe supervision
- Unsafe acts or preconditions for unsafe acts
Define the term human factor.
Environmental, organisational and job factors, as well as human characteristics which can influence behaviour at work in a way that can affect health and safety
How do healthcare systems use human factors?
- Enhance clinical performance through understanding of teamwork, tasks, understanding, culture and organisation on human behaviour and abilities
- Aims to minimise human error and maximise patient safety
- Exists on both individual and social levels
What is the role of an effective leader?
- Direct and coordinate a team
- Encourage teamwork
- Develop team knowledge, skills and attitudes
- To encourage and motivate
- To plan and organise
What is the role of an effective follower?
- Acts to support and enable a leader’s decisions towards the goal of the whole team
- Good followers are active, think independently and contribute
Describe the process of workload distribution.
- No individual should do everything or nothing
- A role should not be allocated to someone who clearly does not have the experience to carry it out
What is situational awareness?
- Ability to perceive, understand, and effectively respond to one’s situation
What are the 3 keys to situational awareness?
Information needs to be
- Gathered accurately
- Remembered and sorted into working memory
- Processed to anticipate future changes
What are the main threats to situational awareness?
Confirmation bias
Conformation bias
Poor communication
High workload or stress
Low motivation
What are the 4 steps of good decision making?
- Assessing the situation and defining the problem
- Generation of possible solutions
- Selecting and implementing a solution
- Reviewing the outcome
What is recognition primed decision making and what are its advantages and disadvantages?
- When experience is used to intuitively decide how to proceed, even under uncertain and potentially high stakes conditions
- ADVANTAGES - rapid recognition, less mental effort involved
- DISADVANTAGES - need for a correctly identified situation, difficult to justify if erroneous
What is rule based decision making and what are its advantages and disadvantages?
- Decision making has been based on set out rules
- ADVANTAGES - Rules have been created in a calm state, easier to justify
- DISADVANTAGES - Can be time consuming, wrong rule may be selected or rule may be updated, people can still make mistakes even when following a protocol
Describe the tiers of stress.
- Certain levels required for good performance
- If increased above a certain level, opposite effect i.e irritability, burnout, ill health and general poor performance
Describe fatigue.
- May be associated with lack of sleep, poor work-life balance
- Negative effect on cognitive function, motor and social skills and communication
