Single-center task analysis and user-centered assessment of physical space impacts on emergency Cesarean delivery.

OBJECTIVE: This study aimed to begin to address this gap using validated techniques in human factors to perform a participatory user-centered analysis of physical space during emergency Cesarean. METHODS: This study employed a mixed-methods design. Focus group interviews and surveys were administered to a convenience sample (n = 34) of multidisciplinary obstetric teams. Data collected from focus group interviews were used to perform a task and equipment analysis. Survey data were coded and mapped by specialty to identify reported areas of congestion and time spent, and to identify themes related to physical space of the OR and labor and delivery unit. RESULTS: Task analysis revealed complex interdependencies between specialties. Thirty task groupings requiring over 20 pieces of equipment were identified. Perceived areas of congestion and areas of time spent in the OR varied by clinical specialty. The following categories emerged as main challenges encountered during an emergency Cesarean: 1) size of physical space and equipment, 2) layout and orientation, and 3) patient transport. CONCLUSION: User insights on physical space and workflow processes during emergency Cesarean section at the institution studied revealed challenges related to getting the patients into the OR expediently and having space to perform tasks without crowding or staff injury. By utilizing human factors techniques, other institutions may build upon our findings to improve safety during emergency situations on labor and delivery.

Healthcare handoffs among lay caregivers.

BACKGROUND: Much of home healthcare is also performed by informal caregivers. This paper seeks to add understanding to the home healthcare field, specifically studying care handoffs between informal caregivers. This study included 16 trained and 20 lay participants to determine differences due to expertise. This comparison is useful because there is a lot of published research on healthcare handoff happenings involving healthcare professionals, and the results indicate how much of the published research can be applied to care handoffs between informal caregivers. OBJECTIVE: The primary objective of this study is to identify differences between lay and professional caregivers when there is uncertainty in a caregiving handoff from their fellow caregiver. METHODS: The study design included between-group analysis of Expertise (layman and expert) and within-group analysis of Task Difficulty and Communication Modality. Dependent variables included willingness to ask for help, confidence in handoff instructions, confidence in the ability to complete tasks and task accuracy. Both Expertise groups were given the same four scenarios in a repeated measures study design. RESULTS: The findings suggest statistically significant differences in how informal caregivers respond to unclear handoff instructions, where lay participants were more confident in understanding instructions, more confident in executing the tasks, less willing to ask for help and also less able to spot and resolve conflicting information compared to trained participants. Lower performance in resolving conflicting information was exhibited by the lay participants. However, when comparing with the syringes that were prepared correctly, it was observed that the accuracy of those prepared syringes was higher for lay participants than for trained participants. CONCLUSION: It was anticipated that lay participants would be more willing to ask for help due to lack of subject matter expertise and trained participants would be more confident in completing tasks due to their superior subject matter expertise, but the opposite was true in both cases. It was also anticipated that lay and trained participants would be equally confident of the instructions given by their fellow caregiver, yet trained participants were less confident. The results from this study have impacts on the design of instructions (often by formal caregivers) for informal caregivers.

Interactive tools for safety 4.0: virtual ergonomics and serious games in real working contexts.

This paper presents an innovative safety training method based on digital ergonomics simulations and serious games, which are games that focus on education. Digital ergonomics is intended to disseminate the culture of safety among workers, while serious games are used to train the operators on specific safety procedures and verify their skills. The results of the experimentation in a real industrial environment showed that, compared to the traditional training methodology, multimedia contents and quantitative ergonomic analyses improve the level of attention and the awareness of the workers about their own safety. However, serious games turned out to be promising training tools with regard to standard operating procedures that are usually difficult or dangerous to simulate in a real working scenario without stopping production. Practitioner summary: Digital ergonomics and serious games are used to disseminate the culture of safety among the workers and for safety training. Our results show that the proposed methodology improves the level of attention and provides a better feedback about the actual skills of the workers than the standard educational strategies. Abbreviations.

Elaborating the Human Aspect of the NIST Framework for Cyber-Physical Systems.

The National Institute of Standards and Technology (NIST) has developed a Framework for Cyber-Physical Systems (CPS Framework) that supports system engineering analysis, design, development, operation, validation and assurance of CPS. Cyber-physical systems (CPS) comprise interacting digital, analog, physical, and human components engineered for function through integrated physics and logic. For instance, a city implementing an advanced traffic management system including real-time predictive analytics and adaptation/optimization must consider all aspects of such a CPS system of systems' functioning and integrations with other systems, including interactions with humans. One Aspect (or grouping of stakeholder concerns) of the CPS Framework is the Human Aspect. NIST is engaging HFES in a panel discussion to elaborate Human Aspect concerns, especially relevant constructs, measures, methods, and tools.

The effects of split keyboard geometry on upper body postures.

Split, gabled keyboard designs can prevent or improve upper extremity pain among computer users; the mechanism appears to involve the reduction of awkward wrist and forearm postures. This study evaluated the effects of changes in opening angle, slope and height (independent variables) of a gabled (14 degrees) keyboard on typing performance and upper extremity postures. Twenty-four experienced touch typists typed on seven keyboard conditions while typing speed and right and left wrist extension, ulnar deviation, forearm pronation and elbow position were measured using a motion tracking system. The lower keyboard height led to a lower elbow height (i.e. less shoulder elevation) and less wrist ulnar deviation and forearm pronation. Keyboard slope and opening angle had mixed effects on wrist extension and ulnar deviation, forearm pronation and elbow height and separation. The findings suggest that in order to optimise wrist, forearm and upper arm postures on a split, gabled keyboard, the keyboard should be set to the lowest height of the two heights tested. Keyboard slopes in the mid-range of those tested, 0 degrees to -4 degrees, provided the least wrist extension, forearm pronation and the lowest elbow height. A keyboard opening angle in the mid-range of those tested, 15 degrees, may provide the best balance between reducing ulnar deviation while not increasing forearm pronation or elbow separation. These findings may be useful in the design of computer workstations and split keyboards. The geometry of a split keyboard can influence wrist and forearm postures. The findings of this study are relevant to the positioning and adjustment of split keyboards. The findings will also be useful for engineers who design split keyboards.