Using the Systems Engineering Initiative for Patient Safety (SEIPS) model to describe critical care nursing during the SARS‐CoV‐2 pandemic (2020)

Abstract

globally, there were over 1.3 million confirmed Covid-19 cases and 55 000 cases in the United Kingdom (WHO). 1 The Covid-19 pandemic is the greatest challenge faced by the National Health Service (NHS) to date. Recent data from the United Kingdom-based Intensive Care and National Audit Research centre (ICNARC) database 2 suggests patient mortality rates are almost double those of common viral pneumonia seen in intensive care unit (ICU) patients (50.1% vs 22.4%). In ventilated patients, ICU mortality is even higher (67%), 2 but interpretation should be cautious until further outcomes of this population become known. Severity of respiratory failure and high contagion index of SARS-Cov-2 has caused unprecedented patient numbers needing a high-dependency unit (HDU) or ICU. 3 In response, NHS ICUs have nationally increased bed capacity, 4 utilized staffing models not seen before, 5 and changed medical strategies. Previous pandemic preparedness models have highlighted "fourSs" that include: space (beds), staff (clinicians and operations), stuff (physical equipment), and system (co-ordination). 6 The Systems Engineering Initiative for Patient Safety (SEIPS) human factors model potentially offers a more comprehensive framework by focusing on health care structures, relationships, and processes. 7 It consists of five key domains: person, task, tools and technology, environment, and organization. The SEIPS model 7 may facilitate a pragmatic approach in provisioning for pandemic preparedness, incorporating additional elements of task, tools, and technology. The systematic framework of this model provides the opportunity and means to examine the Covid-19 pandemic while utilizing real-time experiences from the frontline. How to cite this article: Lumley C , Ellis A , Ritchings S , Venes T , Ede J . Using the Systems Engineering Initiative for Patient Safety (SEIPS) model to describe critical care nursing during the SARS-CoV-2 pandemic (2020).

Building a Covid-19 secure intensive care unit: A human-centred design approach

“…Reducing time away from the patient is essential for any future ICU design given the high workload and lower nurse to patient ratios employed during the Covid-19 pandemic. 3 Another overarching functional design driver evident within this data was ensuring that the ICU design was Covid-19 secure: meaning that it was fit for purpose, was able to accommodate both highly infectious patients and "normal" ICU patients and minimised infection risks to • Dry and wet sides to bed space (i.e., not placing the ventilator on fluid administration side)…”

Improving the efficiency of nursing work for patients with severe COVID-19

“…During the epidemic period, especially in the early stage of the epidemic, infection rates, and deaths among healthcare staff signi cantly increased [10,11]. The main nursing work of the ICU during novel coronavirus pneumonia is to implement treatment, life care, and psychological nursing for patients with con rmed infection [12][13][14][15][16]. In addition, the nursing work includes cleaning and disinfection of the ward environment, waste sorting and recycling, and in-hospital control [17,18].…”

Selecting a theoretical framework to guide research on the COVID-19 pandemic impacts on nursing care delivery and the critical care work system (using Reed's Intermodern approach to theory critique)

“…There is ample contemporary research evidence supporting the use of the SEIPS 2.0 Model in practice (Center for Quality and Productivity Improvement, n.d.). The SEIPS 2.0 Model was recently used by Lumley et al (2020) to conceptualize what nursing care delivery may look like in critical care settings during the COVID-19 Pandemic. The model has applications for evidence-based practice, quality evaluation, testing interventions, and supporting professional and personal practices promoting personal and professional health and wellbeing as evidenced by inclusion of professional outcomes in the model (Holden et al, 2013).…”