Unfamiliar personal protective equipment: The role of routine practice and other factors affecting healthcare personnel doffing strategies.

Background: Healthcare personnel (HCP) may encounter unfamiliar personal protective equipment (PPE) during clinical duties, yet we know little about their doffing strategies in such situations.

Objective: To better understand how HCP navigate encounters with unfamiliar PPE and the factors that influence their doffing strategies.

Setting: The study was conducted at 2 Midwestern academic hospitals.

Reporting Outcomes of Pediatric Intensive Care Unit Patients to Referring Physicians via an Electronic Health Record-Based Feedback System.

Background: Many critically ill children are initially evaluated in front-line settings by clinicians with variable pediatric training before they are transferred to a pediatric intensive care unit (PICU). Because clinicians learn from past performance, communicating outcomes of patients back to front-line clinicians who provide pediatric emergency care could be valuable; however, referring clinicians do not consistently receive this important feedback.

Objectives: Our aim was to determine the feasibility, usability, and clinical relevance of a semiautomated electronic health record (EHR)-supported system developed at a single institution to deliver timely and relevant PICU patient outcome feedback to referring emergency department (ED) physicians.

Usability of smart infusion pumps: A heuristic evaluation.

Although smart infusion pumps were built to eliminate medication errors, new types of usability errors have arisen. The purposes of this study were to determine potential risks when using smart pumps during secondary medication administration and to identify opportunities for design improvements. We observed and analyzed nurses when they interacted with smart pumps and heuristically evaluated the smart pump to identify usability problems.

BALANCING DOCUMENTATION AND DIRECT PATIENT CARE ACTIVITIES: A STUDY OF A MATURE ELECTRONIC HEALTH RECORD SYSTEM.

Unlabelled: US hospitals now fully embrace electronic documentation systems as a way to reduce medical errors and improve patient safety outcomes. Whether spending time on electronic documentation detracts from the time available for direct patient care, however, is still unresolved. There is no knowledge on the permanent effects of documenting electronically and whether it takes away significant time from patient care when the healthcare information system is mature.

A Theoretical Framework for Understanding Creator-Consumer Information Interaction Behaviors in Healthcare Documentation Systems.

The advent of electronic documentation systems has made it easy to generate and store vast amounts of information, and has enabled easy access to patient care information, so much so that they are now considered a critical infrastructure for supporting the cognitive tasks in healthcare work. But, electronic documentation systems are not without their share of problems. Accountability and liability requirements have made electronic information creation and documentation particularly challenging.

Healthcare Workers' Strategies for Doffing Personal Protective Equipment.

Background: Personal protective equipment (PPE) helps protect healthcare workers (HCWs) from pathogens and prevents cross-contamination. PPE effectiveness is often undermined by inappropriate doffing methods. Our knowledge of how HCWs approach doffing PPE in practice is limited.

A qualitative investigation of healthcare workers' strategies in response to readmissions.

Background: Readmission of a patient to a hospital is typically associated with significant clinical changes in the patient's condition, but it is unknown how healthcare workers modify their provision of care when considering these changes. The purpose of the present study was to determine how healthcare workers shift their care strategies when treating readmitted patients.

Methods: A typical case sampling study of healthcare workers was conducted using the grounded theory approach.

Role of Human Factors Engineering in Infection Prevention: Gaps and Opportunities.

Human factors engineering (HFE), with its focus on studying how humans interact with systems, including their physical and organizational environment, the tools and technologies they use, and the tasks they perform, provides principles, tools, and techniques for systematically identifying important factors, for analyzing and evaluating how these factors interact to increase or decrease the risk of Healthcare-associated infections (HAI), and for identifying and implementing effective preventive measures. We reviewed the literature on HFE and infection prevention and control and identified major themes to document how researchers and infection prevention staff have used HFE methods to prevent HAIs and to identify gaps in our knowledge about the role of HFE in HAI prevention and control. Our literature review found that most studies in the healthcare domain explicitly applying (HFE) principles and methods addressed patient safety issues not infection prevention and control issues.

Technologies in the wild (TiW): human factors implications for patient safety in the cardiovascular operating room.

Unlabelled: We describe different sources of hazards from cardiovascular operating room (CVOR) technologies, how hazards propagate in the CVOR and their impact on cognitive processes. Previous studies have examined hazards from poor design of a specific CVOR technology. However, the impact of different CVOR technologies functioning in context is not clearly understood.

Using human factors engineering to improve patient safety in the cardiovascular operating room.

Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts.

Development of a simulation environment to study emergency department information technology.

Introduction: This article presents a simulation architecture for a patient tracking system simulator to study caregiver performance in emergency departments (EDs). The architecture integrates discrete event simulation modeling with clinical patient information. Evaluation components for electronic patient tracking system displays are also described.