Suchergebnisse

Objective Present a collection of papers focusing on improving healthcare practice through the implementation of human factors and ergonomics principles that were presented at the International Ergonomics Association (IEA) 2021 international conference. Background The mission of the IEA is to elaborate and advance ergonomics science and practice and to expand its scope of application. Method We reviewed papers that were submitted for presentation at the IEA 2021 international conference and focused on improving healthcare practice through the implementation of human factors and ergonomics principles. Results The eight papers that are included in this special issue cover varied aspects of human factors application and implementation. Conclusion This special issue provides clear evidence that the science of human factors is relevant and is continuing to grow and so is its implementation in healthcare. Application This special issue offers a selection of applied works, providing a wide scope of human factors guidelines, methods, and theories in healthcare work environments.

Objective This article analyzes the changes in downloads and activity of users of select popular mental health mobile applications (mHealth apps) during coronavirus disease 2019 (COVID-19). Background The outbreak of the COVID-19 crisis has shown a negative impact on public mental health. Mobile health has the potential to help address the psychological needs of existing and new patients during the pandemic and beyond. Method Downloads data of 16 widely used apps were analyzed. The quality of apps was reviewed using the Mobile Application Rating Scale (MARS) framework. Correlation analysis was conducted to investigate the relationship between app quality and app popularity. Results Among the 16 apps, 10 were meditational in nature, 13 showed increased downloads, with 11 apps showing above 10% increase in the downloads after the pandemic started. The popular apps were satisfactory in terms of functionality and esthetics but lacked clinical grounding and evidence base. There exists a gap between app quality and app popularity. Conclusion This study provided evidence for increased downloads of mental mHealth apps (primarily meditation apps) during the COVID-19 pandemic but revealed several gaps and opportunities to address deficiencies in evidence-based design, usability and effective assessment, and integration into current workflows. Application The COVID-19 pandemic is a potential turning point for mHealth applications for mental health care. Whereas the evidence suggests a need for alternative delivery of care, human factors and ergonomics methods should be utilized to ensure these tools are user-centered, easy to use, evidence-based, well-integrated with professional care, and used sustainably.

Objective We collected naturalistic heart rate data from veterans diagnosed with post-traumatic stress disorder (PTSD) to investigate the effects of various factors on heart rate. Background PTSD is prevalent among combat veterans in the United States. While a positive correlation between PTSD and heart rate has been documented, specific heart rate profiles during the onset of PTSD symptoms remain unknown. Method Veterans were recruited during five cycling events in 2017 and 2018 to record resting and activity-related heart rate data using a wrist-worn device. The device also logged self-reported PTSD hyperarousal events. Regression analyses were performed on demographic and behavioral covariates including gender, exercise, antidepressants, smoking habits, sleep habits, average heart rate during reported hyperarousal events, age, glucocorticoids consumption, and alcohol consumption. Heart rate patterns during self-reported PTSD hyperarousal events were analyzed using Auto Regressive Integrated Moving Average (ARIMA). Heart rate data were also compared to an open-access non-PTSD representative case. Results Of 99 veterans with PTSD, 91 participants reported at least one hyperarousal event, with a total of 1023 events; demographic information was complete for 38 participants who formed the subset for regression analyses. The results show that factors including smoking, sleeping, gender, and medication significantly affect resting heart rate. Moreover, unique heart rate patterns associated with PTSD symptoms in terms of stationarity, autocorrelation, and fluctuation characteristics were identified. Conclusion Our findings show distinguishable heart rate patterns and characteristics during PTSD hyperarousal events. Application These findings show promise for future work to detect the onset of PTSD symptoms.

Objective We aimed to identify opportunities for application of human factors knowledge base to mitigate disaster management (DM) challenges associated with the unique characteristics of the COVID-19 pandemic. Background The role of DM is to minimize and prevent further spread of the contagion over an extended period of time. This requires addressing large-scale logistics, coordination, and specialized training needs. However, DM-related challenges during the pandemic response and recovery are significantly different than with other kinds of disasters. Method An expert review was conducted to document issues relevant to human factors and ergonomics (HFE) in DM. Results The response to the COVID-19 crisis has presented complex and unique challenges to DM and public health practitioners. Compared to other disasters and previous pandemics, the COVID-19 outbreak has had an unprecedented scale, magnitude, and propagation rate. The high technical complexity of response and DM coupled with lack of mental model and expertise to respond to such a unique disaster has seriously challenged the response work systems. Recent research has investigated the role of HFE in modeling DM systems' characteristics to improve resilience, accelerating emergency management expertise, developing agile training methods to facilitate dynamically changing response, improving communication and coordination among system elements, mitigating occupational hazards including guidelines for the design of personal protective equipment, and improving procedures to enhance efficiency and effectiveness of response efforts. Conclusion This short review highlights the potential for the field's contribution to proactive and resilient DM for the ongoing and future pandemics.

Communities face unforeseen threats from natural and human‐made disasters. As disasters grow more intense and critical infrastructure increases in complexity, resilience has emerged as an essential attribute of incident management systems. Despite concerted efforts to examine government organizations and their associated policies, understanding resilience traits exhibited by hospitals and healthcare systems during disasters is limited. We employ two fundamental viewpoints of safety to assess what went wrong (Safety I) and right (Safety II) during Hurricane Harvey in a large regional hospital. Through qualitative analysis of semi‐structured interviews with hospital emergency management and operators, we examine both opportunities and challenges in six aspects of hospital incident management: organizational structure and functions; situational awareness; operating plans; human and physical resources; lessons learned from previous incidents; and leadership and high‐level decision making. The benefits of incorporating both the Safety I and Safety II frameworks in evaluating hospital incident response and the implications of this approach for disaster management policies are discussed.

Objective: Interruptions to secondary tasks resulting in multiple tasks to resume may tax working memory. The objective of this research is to study such interruptions experienced by intensive care unit (ICU) nurses. Background: ICU nurses are frequently interrupted, resulting in a switch from primary to secondary tasks. In two recent studies, we observed that some of these secondary tasks also get interrupted, resulting in multiple tasks that have to be resumed, a phenomenon we refer to as nested interruptions. Although completing multiple secondary tasks in a serial fashion during an interruption period can create context-switching costs, we hypothesize that nested interruptions tax the working memory even more than just performing multiple secondary tasks sequentially because the nurse would have to encode in working memory the resumption goals for both the primary and the interrupted secondary tasks. Method: We conducted a laboratory study with 30 ICU nurses, who performed an electronic order-entry task under three interruption conditions: (a) baseline—no secondary task during the interruption period; (2) serial—performance of two tasks one after the other during the interruption period; and (3) nested—performance of two tasks during the interruption period, one of which was also interrupted. Results: Nested interruptions resulted in significantly longer primary-task resumption lag and less accurate task resumption compared with both the serial interruption and baseline conditions. Conclusion: The nested nature of interruptions adds to the resumption lag and diminishes resumption accuracy by likely populating the working memory with goals associated with interrupted secondary tasks.

ABSTRACTThis article describes the process of designing, approving, and conducting an investigator‐initiated protocol to use an eye‐tracking device in a health care setting. Participants wore the device, which resembles eyeglasses, in a front‐facing manner in an intensive care unit for the study of personnel gaze patterns, producing a visual record of workflow. While the data of interest for our study was not specifically the health information protected by the privacy rule of the Health Insurance Portability and Accountability Act (HIPAA), a wide variety of such data was captured by the eye‐tracking device, and the prospective consent of all people who might have been incidentally videotaped was not feasible. The protocol therefore required attention to unique ethical considerations—including consent, privacy and confidentiality, HIPAA compliance, institutional liability, and the use of secondary data. The richness of eye‐tracker data suggests various beneficial applications in health care occupational research and quality improvement. Therefore, sharing our study's successful design and execution, including proactive researcher‐institutional review board communication, can inform and encourage similarly valuable, ethical, and innovative audiovisual research techniques.

Objective (1) To assess mental workloads of intensive care unit (ICU) nurses in 12-hour working shifts (days and nights) using eye movement data; (2) to explore the impact of stress on the ocular metrics of nurses performing patient care in the ICU. Background Prior studies have employed workload scoring systems or accelerometer data to assess ICU nurses' workload. This is the first naturalistic attempt to explore nurses' mental workload using eye movement data. Methods Tobii Pro Glasses 2 eye-tracking and Empatica E4 devices were used to collect eye movement and physiological data from 15 nurses during 12-hour shifts (252 observation hours). We used mixed-effect models and an ordinal regression model with a random effect to analyze the changes in eye movement metrics during high stress episodes. Results While the cadence and characteristics of nurse workload can vary between day shift and night shift, no significant difference in eye movement values was detected. However, eye movement metrics showed that the initial handoff period of nursing shifts has a higher mental workload compared with other times. Analysis of ocular metrics showed that stress is positively associated with an increase in number of eye fixations and gaze entropy, but negatively correlated with the duration of saccades and pupil diameter. Conclusion Eye-tracking technology can be used to assess the temporal variation of stress and associated changes with mental workload in the ICU environment. A real-time system could be developed for monitoring stress and workload for intervention development.

Objective To identify physiological correlates to stress in intensive care unit nurses. Background Most research on stress correlates are done in laboratory environments; naturalistic investigation of stress remains a general gap. Method Electrodermal activity, heart rate, and skin temperatures were recorded continuously for 12-hr nursing shifts (23 participants) using a wrist-worn wearable technology (Empatica E4). Results Positive correlations included stress and heart rate (ρ = .35, p < .001), stress and skin temperature (ρ = .49, p < .05), and heart rate and skin temperatures (ρ = .54, p = .0008). Discussion The presence and direction of some correlations found in this study differ from those anticipated from prior literature, illustrating the importance of complementing laboratory research with naturalistic studies. Further work is warranted to recognize nursing activities associated with a high level of stress and the underlying reasons associated with changes in physiological responses. Application Heart rate and skin temperature may be used for real-time detection of stress, but more work is needed to validate such surrogate measures.