A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional: 
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Karsh, B-T; Holden, Richard J.; Alper, Samuel J.; Or, Calvin

doi:10.1136/qshc.2005.015974

Cited by 323 publications

(261 citation statements)

References 18 publications

(11 reference statements)

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“…In addition, objective measurements such as attendance and hospitalization of patients in hospital wards provide useful information about healthcare staff's workload dimensions including physical, emotional, and cognitive ones (22). From the human factor point of view, excessive workload in healthcare shows its effect in two forms: First, patient-related outcomes and providing care including patient safety events and quality of healthcare; and second, healthcare staff-related outcomes such as quality of work, satisfaction, and job burnout (23,24).…”

Section: Introductionmentioning

confidence: 99%

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Abadi¹,

Akbari²,

Akbari³

et al. 2016

Iran Red Crescent Med J

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Introduction: Adverse patient outcomes have become a big concern in the quality of healthcare. Different factors can have an impact on the variety and rate of adverse patient outcomes. Objectives: The present study aimed at determining the rate of patient safety during events and evaluating nursing workloads as well as identifying the main factors that affect the incidence rate of patient safety events among nurses. Methods: This cross-sectional study was conducted on 293 nurses working in 24 wards of Baqiyatallah hospital in Tehran, Iran, in 2016. The sampling method was stratified random sampling. Data were collected using a self-administered questionnaire, which was classified into 4 subtitles: Individual and organizational characteristics, perceived subjective, objective workloads, and some patient safety events during the past 6 months. Binary and multiple regressions were used to survey the relationship between variables using the SPSS Version 23 software. Results: Bloodstream infection, pressure ulcer, and patient falls were the most reported adverse outcomes during the past 6 months with 76.1%, 66.2%, and 59%, respectively. At least one of the 6 adverse outcomes was reported by nurses within the range of 45%-77%. Of all individual characteristics, the only significant relationship occurred between work experience and bloodstream infection (P value = 0.28 and 0.32). No significant relationship was detected between adverse patient outcomes and objective workloads. Regression models revealed that the subjective workload of adverse patient outcomes increased with making adjustments in the individual and organizational characteristics. The incidence rates of adverse outcomes were 5.69-9.78 times more than the fixed shifts in all rotational shift works. Conclusions: The nurses reported a high incidence rate of all patient safety events, and the results revealed that the objective workload could not be a predictor for patient adverse events. According to the findings, subjective workload and work shift were significantly related to the incidence rate of adverse patient events. In conclusion, good regulation of sleep-wake cycles can be an important factor for decreasing the rate of adverse patient events.

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Section: Introductionmentioning

confidence: 99%

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Abadi¹,

Akbari²,

Akbari³

et al. 2016

Iran Red Crescent Med J

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show abstract

“…28 Developing a strong communication and teamwork can also contribute to building additional layers of safety into the medication use system and compensate for the inevitable weakness of healthcare professionals 30 -a fundamental tenet in the discipline of human factors engineering. [16][17][18][19] For example, creating a standardized documentation system and a common language around medication use can be a good starting point for the ED and hospital leaders. This is particularly important because of the EDs place as a major training site for trainee resident doctors who may speak a "different language" than the nurses and pharmacists who are …”

Section: Discussionmentioning

confidence: 99%

“…15 The SEIPS model is anchored in the disciplines of human factors and systems engineering-which examine performance of humans and their interactions with technology and the surrounding environment while acknowledging their limitations. [16][17][18][19] According to the SEIPS model, a person (e.g., an ED nurse) performs different tasks (e.g., administration of medications) using various tools and technologies (e.g., medication administration sign-out sheet). These tasks occur within the immediate physical environment (e.g., the ED workspace) under some organizational constraints (e.g., policies guiding medication administration).…”

Section: Study Setting and Designmentioning

confidence: 99%

Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

Abebe

Chui

2018

Innov Pharm

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“…This was a descriptive study using mixed methods [23] with a human factors engineering (HFE) approach [24]. Observers collected data while observing participants during whole shifts.…”

Section: Methodsmentioning

confidence: 99%

What the work of nurses really looks like: Identifying factors influencing the work of nurses in hospital

Bragadóttir

Gunnarsdóttir²,

Ingason³

2014

J Environ Occup Sci

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The aim of this study was to gain deeper understanding of the work of nurses and shed light on the factors influencing their work in acute care. Professional nursing care makes a difference to patient outcomes. Therefore it is important to identify potential improvements in nurses' work to make better use of their knowledge and time for the benefit of patient safety. Method: Participants were 8 registered nurses (RNs) and 10 practical nurses (PNs) in one university hospital, observed during their work. Rich multilayer real-time quantitative data were collected with qualitative field notes on nurses' work, factors influencing their work, movements and time. Following each shift, participants were interviewed by observers. Data were entered onto a handheld computer and a digital recorder during observation. Data collection took place in 2008 and data analysis in 2009-2010. Results: Nursing work was characterized by frequent shifting of attention, interruptions, operational failures, multitasking and constant movements which influenced their work. On average, RNs and PNs encountered influencing factors 4.2 and 2.0 times per hour, respectively, the most common one being face-to-face communication initiated by a co-worker. However, participants described their shifts as quiet and manageable, and without interruptions and delays. Conclusions: Study findings provide a picture of the complex interplay of nurses' work, influencing factors and movements, with frequent attention shifting in chronological order. Participants were interrupted within an interruption leading to layers of interruptions, adding to the complexity of their work. Study findings demonstrate the importance of approaching and measuring nursing work as a complex phenomenon.

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A human factors engineering paradigm for patient safety: designing to support the performance of the healthcare professional: Figure 1

Cited by 323 publications

References 18 publications

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

The Association of Nursing Workloads, Organizational, and Individual Factors with Adverse Patient Outcome

Exploring Barriers to Medication Safety in an Ethiopian Hospital Emergency Department: A Human Factors Engineering Approach

What the work of nurses really looks like: Identifying factors influencing the work of nurses in hospital

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