一个宏观人体工程学分析,以确定对产后出血预测,鉴定和管理的改进
Kaitlyn L Hale-Lopez1, Madelyn M Saenz1, Neelam Verma2
1Department of Industrial and Enterprise Systems Engineering, University of Illinois Urbana-Champaign, 104 South Mathews Ave, Urbana, Illinois 61801, United States.
概括
产后出血 (PPH) 是产后死亡的主要原因之一. 这项研究使用了宏观人体工程学和SEIPS模型来确定753个影响PPH护理的因素,从而提出了四项系统重新设计建议,以提高患者安全.
科学领域:
- 医疗保健系统工程 医疗保健系统工程
- 患者安全研究的研究.
- 提高孕产妇健康质量的改善
背景情况:
- 在全球范围内,产后出血 (PPH) 仍然是孕产妇死亡的主要原因.
- 现有的干预措施还没有完全缓解与PPH相关的死亡.
- 宏观人体工程学和患者安全系统工程倡议 (SEIPS) 模型为分析PPH护理系统提供了新的方法.
研究的目的:
- 应用宏观人体工程学原理和SEIPS模型来了解导致PPH死亡率的系统因素.
- 确定PPH护理连续的特定领域 (预测,识别,管理) 以提高安全.
- 为重新设计PPH工作系统制定基于证据的建议.
主要方法:
- 在PPH场景中进行了37.6小时的直接患者护理观察.
- 利用基于SEIPS的流程建模来可视化护理途径.
- 对29名临床医生进行了面试和焦点小组的主题内容分析,以确定影响因素.
主要成果:
- 在剖腹产和阴道分娩期间开发基于SEIPS的PPH护理过程图.
- 确定了753个影响PPH护理质量的因素,分为13个维度.
- 关键的维度包括角色模两可,预期,物理环境,人员,资源,工具,沟通,协调,合作,默认的知识,时间压力,领导力和培训.
结论:
- 提出了四个系统设计考虑因素,以提高PPH管理中的患者安全.
- 建议包括正式确定临床医生和资源协调,整合护理点工具,改善患者房间照明和重新设计PPH风险评估工具.
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