As I was thumbing through the July edition of American Nurse Today, there was a fascinating article by Susan Tocco about human factors engineering1 as a tool to improve patient safety. The three domains of human factors engineering (also known as ergonomics) include workplace layout (physical), mental processes (cognitive), and communication and teamwork (organizational). These concepts relate almost directly to several of the findings of the “Top 10 Clinical Communication Trends,” the national clinical communication survey we conducted earlier this year.
Workplace layout can impact the communication pathways chosen by nurses and create the need for the “hunting and gathering” that can consume such a large portion of a nurse’s shift. The mental processes used to care for several different patients and their varied needs for 12 or more hours require that the nurse be attentive and sharp. But like everyone, there are days when we are our best and days when we miss out on our “beauty sleep,” or are distracted by physical or emotional stressors. Medication administration is a perfect example of this cognitive process and the patient safety risks that can occur if nurses are interrupted during this task. Data confirms the negative outcomes that can occur when communication and teamwork are lacking.2
Ms. Tocco goes on to suggest several workplace condition threats that can reduce nursing performance, including poorly designed workflow, poor communication and inadequate time. All these issues can be positively impacted by the judicious use of smartphones in the healthcare environment.
The problem is, our current devices and applications still require us to thoughtfully consider the human factors surrounding device use. But, should or could our vision of tomorrow’s environment include a device that provides the safety net and logic to protect us from our own human traits as they relate to patient safety?
As my grandfather used to say, “That is the $64,000 question,” which when adjusted for inflation might be a new way to look at the “cost” of caring, literally.
1. Tocco, S. (2013). Human factor engineering can improve patient safety. American Nurse Today, 8(7), 34-35.
2. Archives of Internal Medicine. (April 26, 2010). Association of Interruptions with an Increased Risk and Severity of Medication Administration Errors. Johanna I. Westbrook, Ph.D., University of Sydney, Australia, and colleagues.