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Biomedical subjects

Pascale Carayon

Publications and source records attributed to Pascale Carayon.

10 recordsLinked to original sources
PubMed2006

Using failure mode and effects analysis to plan implementation of smart i.v. pump technology.

PURPOSE: Failure mode and effects analysis (FMEA) was used to evaluate a smart i.v. pump as it was implemented into a redesigned medication-use process. SUMMARY: A multidisciplinary team conducted a FMEA to guide the implementation of a smart i.v. pump that was designed to prevent pump programming errors. The smart i.v. pump was equipped with a dose-error reduction system that included a pre-defined drug library in which dosage limits were set for each medication. Monitoring for potential failures and errors occurred for three months postimplementation of FMEA. Specific measures were used to determine the success of the actions that were implemented as a result of the FMEA. The FMEA process at the hospital identified key failure modes in the medication process with the use of the old and new pumps, and actions were taken to avoid errors and adverse events. I.V. pump software and hardware design changes were also recommended. Thirteen of the 18 failure modes reported in practice after pump implementation had been identified by the team. A beneficial outcome of FMEA was the development of a multidisciplinary team that provided the infrastructure for safe technology implementation and effective event investigation after implementation. With the continual updating of i.v. pump software and hardware after implementation, FMEA can be an important starting place for safe technology choice and implementation and can produce site experts to follow technology and process changes over time. CONCLUSION: FMEA was useful in identifying potential problems in the medication-use process with the implementation of new smart i.v. pumps. Monitoring for system failures and errors after implementation remains necessary.

Equipment Safety↗
PubMed2006

Human errors and violations in computer and information security: the viewpoint of network administrators and security specialists.

This paper describes human errors and violations of end users and network administration in computer and information security. This information is summarized in a conceptual framework for examining the human and organizational factors contributing to computer and information security. This framework includes human error taxonomies to describe the work conditions that contribute adversely to computer and information security, i.e. to security vulnerabilities and breaches. The issue of human error and violation in computer and information security was explored through a series of 16 interviews with network administrators and security specialists. The interviews were audio taped, transcribed, and analyzed by coding specific themes in a node structure. The result is an expanded framework that classifies types of human error and identifies specific human and organizational factors that contribute to computer and information security. Network administrators tended to view errors created by end users as more intentional than unintentional, while errors created by network administrators as more unintentional than intentional. Organizational factors, such as communication, security culture, policy, and organizational structure, were the most frequently cited factors associated with computer and information security.

Computer Communication Networks↗
PubMed2006

Human factors of complex sociotechnical systems.

Increasingly products and services result from interactions among people who work across organizational, geographical, cultural and temporal boundaries. This has major implications for human factors and ergonomics (HFE), in particular, challenging the limits of the systems to be designed, and widening the range of system elements and dimensions that we need to consider. The design of sociotechnical systems that involve work across multiple boundaries requires better integration of the various sub-disciplines or components of HFE, as well as increased collaboration with other disciplines that provide either expertise regarding the domain of application or expertise in concepts that can enrich the system design. In addition, 'customers' contribute significantly to the 'co-production' of products/services, as well as to their quality/safety. The design of sociotechnical systems in collaboration with both the workers in the systems and the customers requires increasing attention not only to the design and implementation of systems, but also to the continuous adaptation and improvement of systems in collaboration with customers. This paper draws from research on human factors in the domains of health care and patient safety and of computer security.

Community Participation↗
PubMed2006

Customer orientation among employees in public administration: a transnational, longitudinal study.

The relation between ergonomic principles and quality management initiatives, both, in the private and public sector, has received increasing attention in the recent years. Customer orientation among employees is not only an important quality principle, but also an essential prerequisite for customer satisfaction, especially in service organizations. In this context, the objective of introducing new public management (NPM) in public-service organizations is to increase customer orientation among employees who are at the forefront of service providing. In this study, we developed a short scale to measure perceived customer orientation. In two separate longitudinal studies carried out in Austria and the US, we analyzed changes in customer orientation resulting from the introduction of NPM. In both organizations, we observed a significant increase in customer orientation. Perceived customer orientation was related to job characteristics, organizational characteristics and employee quality of working life. Creating positive influences on these characteristics within the framework of an organizational change process has positive effects on employee customer orientation.

Austria↗
PubMed2005

The effect of safety initiatives on safety performance: a longitudinal study.

Construction industry is one of the most dangerous industries, not only in the USA, but worldwide. In this longitudinal study we examined the effects of safety initiatives on the safety performance of construction companies. One of the measures commonly used in the USA to track a company's safety performance is the experience modification rate (EMR). The EMR is based on the company's safety records (injury claims) from the past three full years and is used to calculate the workers' compensation insurance premiums. In a longitudinal study, we studied the effects of safety efforts and initiatives on the EMR. The results show that safety initiatives and money spent on safety do improve safety performance, but only over time.

Accident Prevention↗
PubMed2005

A human factors engineering conceptual framework of nursing workload and patient safety in intensive care units.

In this paper, we review the literature on nursing workload in intensive care units (ICUs) and its impact on patient safety and quality of working life of nurses. We then propose a conceptual framework of ICU nursing workload that defines causes, consequences and outcomes of workload. We identified four levels of nursing workload (ICU/unit level, job level, patient level, and situation level), and discuss measures associated with each of the four levels. A micro-level approach to ICU nursing workload at the situation level is proposed and recommended in order to reduce workload and mitigate its negative impact. Performance obstacles are conceptualized as causes of ICU nursing workload at the situation level.

Attitude to Health↗
PubMed2005

Designing a technology enhanced practice for home nursing care of patients with congestive heart failure.

This paper describes the process we used to design the HeartCare website to support Technology Enhanced Practice (TEP) for home care nurses engaged in providing care for patients with Congestive Heart Failure (CHF). Composed of communication, information, and self-monitoring functions, the HeartCare website is aimed at supporting best practice nursing care for these patients. Its unique focus is professional practice, thus the scope of this project is greater and more abstract than those focusing on a task or set of activities. A modified macroergonomic analysis, design work system analysis, and focus groups utilizing participatory design methodology were undertaken to characterize the nursing practice model. Design of the HeartCare website required synthesizing the extant practice model and the agency's evidence-based heart failure protocols, identifying aspects of practice that could be enhanced by supporting technology, and delineation of functional requirements of the Enhanced HeartCare technology. Validation and refinement of the website and planning for user training activities will be accomplished through a two-stage usability testing strategy.

Community Health Nursing↗
PubMed2004

Job characteristics as mediators in SES-health relationships.

We focus on physical and psychosocial job characteristics as mediators in the relationship between socioeconomic status (SES) and health. From sociological research on the stratification of employment outcomes we expect that people with less education, lower earnings, and lower levels of occupational standing have more physically and psychosocially demanding jobs. From the occupational stress, ergonomics, and job design literatures, we expect that people with more physically and psychosocially demanding jobs have less favorable health outcomes. Consequently, we expect to find that job characteristics play an important mediating role in associations between SES and self-assessed overall health and cardiovascular and musculoskeletal health problems. To address these hypotheses, we use data from the Wisconsin Longitudinal Study (WLS). We find support for our hypotheses, although the extent to which job characteristics mediate SES-health relationships varies across health outcomes and by sex.

Cardiovascular Diseases↗
PubMed2004

Righting wrong site surgery.

BACKGROUND: As defined by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), wrong site surgery includes wrong side or siteof the body, wrong procedure, and wrong-patient surgeries. Although many health care organizations are implementing guidelines and procedures to decrease the occurrence of wrong site surgery, numerous barriers to their effectiveness have been identified. HUMAN FACTORS ENGINEERING (HFE) ANALYSIS: A human factors system analysis can be used to better understand how elements of a work system combine andinteract to contribute to breakdowns in the system. A case study of wrong site surgery in an outpatient setting illustrates how the different work systtem elements can contribute to the occurrence of a wrong site surgery. In analyzing the care process, it is particularly important to identify the transitions of care, which can be sources of patient safety problems when deficits in communication and information transfer occur (for example, miscommunication, information not transmitted on time, wrong information transmitted, misunderstanding of the information transmitted). RECOMMENDATIONS: After a wrong site surgery, conduct a root cause analysis that uses the work system model and includes a surgery care process analysis similar to the one described in the case study; collaborate with human factors engineers to learn how to apply the work system model; apply the work system model to process analysis; and optimize work systems.

Aged↗