Presentation Title
Human Factors, Nursing Practice, and Patient Safety: Heuristic Evaluation Method to Identify Patient Controlled Analgesia System Design and Performance Issues
Format
Event
Start Date
10-2-2012 12:00 AM
Abstract
Objective. To demonstrate the heuristic evaluation (HE), an analytic usability inspection method and describe design/performance issues of a patient controlled analgesia (PCA) system affecting nursing practice and patient safety. Background. PCAs were designed to improve patient outcomes and safety. From 2005-2009, 6,069 PCA injuries/deaths were reported to the FDA. The frequency and severity of errors warrant the innovative application of methods to mitigate error. Human factors evidence supports HE as a method to promote safety in high-risk industries such as nursing and to identify usability problems contributing to medical errors. Methods. Relevant heuristic principles were selected from the literature. Four evaluators independently conducted HEs of the PCA system. Evaluators (a) rated PCA adherence to each of 10 heuristic principles on a 5-point scale, (b) identified usability concerns, and (c) rated severity of usability concerns on a 5-point scale. Usability concerns provided evidence of deviations from the principles and context for the each heuristic severity rating. Results. Preliminary results indicated PCA adherence ratings for aesthetic (median = 3.00, SD = .50) and error (median = 3.00, SD = 1.00) adhered most closely to their respective heuristics; visibility (median = .50, SD = 1.41) and flexibility (median = .50, SD = .58) adhered the least. Evaluators recorded usability concerns (n = 69) in free form for each heuristic. Severity rating were lowest for flexibility and aesthetic (median = 1.00, SD = 1.50). Conclusion. When automated system design departs from established standards, a myriad of usability and performance concerns arise that may inadvertently contribute to error, compromising patient safety. These finding may justify changes to organizational polices relating to PCA system selection and support for purchase planning, or address nurses training to offset system shortcomings. Future research should address the strategies for implementing heuristic evaluations in organizational medical device decisionmaking.
Human Factors, Nursing Practice, and Patient Safety: Heuristic Evaluation Method to Identify Patient Controlled Analgesia System Design and Performance Issues
Objective. To demonstrate the heuristic evaluation (HE), an analytic usability inspection method and describe design/performance issues of a patient controlled analgesia (PCA) system affecting nursing practice and patient safety. Background. PCAs were designed to improve patient outcomes and safety. From 2005-2009, 6,069 PCA injuries/deaths were reported to the FDA. The frequency and severity of errors warrant the innovative application of methods to mitigate error. Human factors evidence supports HE as a method to promote safety in high-risk industries such as nursing and to identify usability problems contributing to medical errors. Methods. Relevant heuristic principles were selected from the literature. Four evaluators independently conducted HEs of the PCA system. Evaluators (a) rated PCA adherence to each of 10 heuristic principles on a 5-point scale, (b) identified usability concerns, and (c) rated severity of usability concerns on a 5-point scale. Usability concerns provided evidence of deviations from the principles and context for the each heuristic severity rating. Results. Preliminary results indicated PCA adherence ratings for aesthetic (median = 3.00, SD = .50) and error (median = 3.00, SD = 1.00) adhered most closely to their respective heuristics; visibility (median = .50, SD = 1.41) and flexibility (median = .50, SD = .58) adhered the least. Evaluators recorded usability concerns (n = 69) in free form for each heuristic. Severity rating were lowest for flexibility and aesthetic (median = 1.00, SD = 1.50). Conclusion. When automated system design departs from established standards, a myriad of usability and performance concerns arise that may inadvertently contribute to error, compromising patient safety. These finding may justify changes to organizational polices relating to PCA system selection and support for purchase planning, or address nurses training to offset system shortcomings. Future research should address the strategies for implementing heuristic evaluations in organizational medical device decisionmaking.