Taking ergonomics to the bedside--a multi-disciplinary approach to designing safer healthcare.

A multi-disciplinary approach to designing safer healthcare was utilised to investigate risks in the bed-space in elective surgical wards. The Designing Out Medical Error (DOME) project brought together clinicians, designers, psychologists, human factors and business expertise to develop solutions for the highest risk healthcare processes. System mapping and risk assessment techniques identified nearly 200 potential failure modes in hand hygiene, isolation of infection, vital signs monitoring, medication delivery and handover of information.

Targeted distribution of National Patient Agency Safer Practice Notice on throat packs.

Using an electronic questionnaire, we tested the effectiveness of professional networks for distributing a National Patient Safety Agency Safer Practice Notice, 'Reducing the risk of retained throat packs after surgery', issued in April 2009. Using professional networks for the targeted distribution of guidance to specific professional groups was found to be effective.

The diversity of human factors: illustrating the relevance for nursing.

This article looks at a selection of human factors tools and activities that may be used in nursing practice to improve the safety of patient care. The Human Factors Walk-Around tool and the Foresight training programme are highlighted as means to raise awareness of systems factors that may compromise safety. Ideas are given on how to improve team skills, to consider risk proactively, and to influence the design of the healthcare system in which care is delivered.

The importance of applying human factors to nursing practice.

The aim of this series is to introduce the topic of human factors and to show how it can be used in nursing practice on the ward and in nursing management, to improve the safety of patient care. Human factors can be used to make many aspects of working life easier, and if it is easier to do it is less likely to go wrong. This article discusses the importance of human factors in nursing and provides some practical suggestions on how to apply the principles of human factors.

Multidisciplinary obstetric simulated emergency scenarios (MOSES): promoting patient safety in obstetrics with teamwork-focused interprofessional simulations.

Introduction: We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined.

Methods: Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England.

Human factors and safe patient care.

Aims: This paper aims to introduce the topic of human factors to nursing management and to identify areas where it can be applied to patient safety.

Background: Human factors is a discipline established in most safety critical industries and uses knowledge about human behaviour in the analysis and design of complex systems, yet it is relatively new to many in healthcare.

Evaluation: Most safety critical industries have developed tools and techniques to apply human factors to system design, and these have been reviewed together with those resources already available for use in healthcare.

Designing evidence-based patient safety interventions: the case of the UK's National Health Service hospital wristbands.

Rationale, Aims And Objectives: Current evidence suggests that hospital inpatient identification wristbands are not used optimally. Here we report a project by the National Patient Safety Agency (NPSA) to inform guidance development to hospitals regarding wristband specifications.

Method: A survey assessed (i) the information on wristbands; (ii) the processes of issuing/checking/applying wristbands onto patients; (iii) the types/designs of wristbands (including colour-coding); and (iv) the main problems faced by staff face in relation to wristbanding patients.

Closing the safety loop: evaluation of the National Patient Safety Agency's guidance regarding wristband identification of hospital inpatients.

Rationale, Aims And Objectives: Wristbands are essential for accurate patient identification. Some evidence suggests that missing wristbands is not an infrequent occurrence in acute hospitals. The National Patient Safety Agency (NPSA) has developed guidance on patient identification for hospitals in England and Wales.

Medical device development: the challenge for ergonomics.

High quality, well-designed medical devices are necessary to provide safe and effective clinical care for patients as well as to ensure the health and safety of professional and lay device users. Capturing the user requirements of users and incorporating these into design is an essential component of this. The field of ergonomics has an opportunity to assist, not only with this area, but also to encourage a more general consideration of the user during medical device development.

Capturing user requirements in medical device development: the role of ergonomics.

Measuring and fulfilling user requirements during medical device development will result in successful products that improve patient safety, improve device effectiveness and reduce product recalls and modifications. Medical device users are an extremely heterogeneous group and for any one device the users may include patients and their carers as well as various healthcare professionals. There are a number of factors that make capturing user requirements for medical device development challenging including the ethical and research governance involved with studying users as well as the inevitable time and financial constraints.

Rail human factors: Past, present and future.

Rail human factors research has grown rapidly in both quantity and quality of output over the past few years. There was an early base of work at a few institutions carried out over the 1960s and 1970s, followed by a lull in the 1980s and early 1990s. The continual influences of safety concerns, new technical system opportunities, reorganisation of the business, needs to increase effective, reliable and safe use of capacity, and increased society, media and government interest have now accelerated rail human factors research programmes in several countries.

The Integrated Workload Scale (IWS): a new self-report tool to assess railway signaller workload.

Network Rail, who own the railway infrastructure in the UK, have been interested in the assessment of mental workload (MWL) of signallers and control staff for some years. A new model of MWL has been proposed within which to develop a suite of new MWL analytical and empirical assessment tools. One of these is the Integrated Workload Scale (IWS), developed and tested for signallers.

Changes in the body size of UK and US children over the past three decades.

The major sources of published anthropometric data on children are now over two decades old. Due to concern being expressed regarding the continued validity of such data, changes in the body sizes of the UK child population over the past three decades have been considered. Comparisons were also made between the size of the current UK child population to the current US child population, and to the most comprehensive source of measured data on US children (but which are now over 20 years old).

The design of child restraint system (CRS) labels and warnings affects overall CRS usability.

A study was conducted that assessed the effectiveness of different child restraint system (CRS) label/warning designs on users' installation performance. Forty-eight paid participants installed a convertible CRS in a vehicle, and two child test dummies in a CRS, using one of four label conditions. The label conditions were: (1) no labels, (2) the manufacturer's labels that were already affixed to the CRS ("Current"), (3) labels that were designed according to a combination of the current U.

Preventing drowning through design--the contribution of human factors.

A number of routes can be followed towards the prevention of drowning, such as educating on water safety, installing barriers between non-intended users and water, mitigating the consequences of submersion incidents, and design. The human factor approach to safety is that design should always be the primary route. Human factors can be applied to the design of personal protective equipment such as buoyancy aids, barriers such as pool fencing, ancillary equipment such as swimming pool covers through to information and organisational factors such as safety signs and swimming campaigns.

Reducing the risk of choking hazards: mouthing behaviour of children aged 1 month to 5 years.

Young children have a natural tendency to mouth items to explore their environment. Mouthing carries mechanical and chemical hazard potential for injury to the child, for example if they swallow an item they may choke, they may cut themselves on sharp items, and certain chemicals are present in plastic items which may pose a risk to children. Few data are available on the time that young children mouth items, how they mouth, and what they mouth.

Filling 'gaps' in strength data for design.

Data on the physical strength capabilities of users are fundamental to the safe and usable design of products. It is recognised, however, that there are many 'gaps' in the ergonomics data available to designers. Whilst considerable research on human capabilities and limitations has already been carried out, few data exist which are directly applicable in the design process.