Evaluation of Protocol Uniformity Concerning Laparoscopic Cholecystectomy in The Netherlands

Background: Iatrogenic bile duct injury remains a current complication of laparoscopic cholecystectomy. One uniform and standardized protocol, based on the "critical view of safety" concept of Strasberg, should red

Safety challenges of medical equipment in nurse anaesthetist training in Haiti

Safety challenges related to the use of medical equipment were investigated during the training of nurse anaesthetists in Haiti, using a systems approach to Human Factors and Ergonomics (HFE). The Observable Performance Obstacles tool, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, was used in combination with exploratory observations during 13 surgical procedures, to identify performance obstacles created by the systemic interrelationships of medical equipment. The identification of performance obstacles is an effective way to study the accumulation of latent factors and risk hazards, and understand its implications in practice and behaviour of healthcare practitioners. In total, 123 performance obstacles were identified, of which the majority was related to environmental and organizational aspects. These findings show how the performance of nurse anaesthetists and their relation to medical equipment is continuously affected by more than user-related aspects. The contribution of systemic performance obstacles and coping strategies to enrich system design interventions and improve healthcare system is highlighted. In addition, methodological challenges of HFE research in low-resource settings related to professional culture and habits, and the potential of community ergonomics as a problem-managing approach are described. (C) 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved

The ten characteristics of the critical task: Ergonomic analysis of vitality requirements in aortic valve surgery

This research forms a part of the design of a system for the resection and implantation of an aortic valve. Four transapical endovalve implantations are analyzed with a view to characterizing the exceptional criticality of this surgical procedure. We demonstrate that the surgeon’s activity is largely cognitive, operational and social and requires mastery of a critical task, i.e. the performance and supervision of a risky, deliberately initiated procedure with an uncertain outcome. The concept of “critical task” is used to describe tasks combining potentially extreme seriousness and potential success, risk-taking with cure. The task is critical as its criticality is intentionally generated by the surgical team. In short, this paper defines the concept of critical task according to ten characteristics: Deliberate, Uniqueness, Learning restriction, Planning, Expertise, Preparation, Collective, Hazardous, Rigidity and Uncertain outcome; and supplies a number of ergonomic recommendations with a view to improvement.SCOPUS: cp.kinfo:eu-repo/semantics/publishe