Human reliability analysis of bronchoscope-assisted percutaneous dilatational tracheostomy: implications for simulation-
- PDF / 582,877 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 191 Views
RESEARCH
Open Access
Human reliability analysis of bronchoscopeassisted percutaneous dilatational tracheostomy: implications for simulationbased education Aoife Lavelle1, Mary White1, Mark J.D. Griffiths1, Dara Byrne2 and Paul O’Connor2,3*
Abstract Background: Teaching and assessing clinical procedures requires a clear delineation of the individual steps required to successfully complete the procedure. For decades, human reliability analysis (HRA) has been used to identify the steps required to complete technical procedures in higher risk industries. However, the use of HRA is uncommon in healthcare. HRA has great potential supporting simulation-based education (SBE) in two ways: (1) to support training through the identification of the steps required to complete a clinical procedure; and (2) to support assessment by providing a framework for evaluating performance of a clinical procedure. The goal of this study was to use HRA to identify the steps (and the risk associated with each of these steps) required to complete a bronchoscope-assisted percutaneous dilatational tracheostomy (BPDT). BPDT is a potentially high-risk minimally invasive procedure used to facilitate tracheostomy placement at the bedside or in the operating theatre. Methods: The subgoals, or steps, required to complete the BPDT procedure were identified using hierarchical task analysis. The Systematic Human Error Reduction and Prediction Approach (SHERPA) was then used to identify potential human errors at each subgoal, the level of risk and how these potential errors could be prevented. Results: The BPDT procedure was broken down into 395 subgoals, of which 18% were determined to be of highrisk. The most commonly identified remediation strategies for reducing the risk of the procedure included: checklist implementation and audit, statutory and mandatory training modules, simulation training, consultant involvement in all procedures, and fostering a safety-focused hospital culture. Conclusion: This study provides an approach for how to systematically identify the steps required to complete a clinical procedure for both training and assessment. An understanding of these steps is the foundation of SBE. HRA can identify ‘a correct way’ for teaching learners how to complete a technical procedure, and support teachers to give systematic and structured feedback on performance. Keywords: Bronchoscope assisted percutaneous dilatational tracheostomy, Hierarchical task analysis, Human reliability analysis, Simulation
* Correspondence: [email protected] 2 Irish Centre for Applied Patient Safety and Simulation, National University of Ireland, Galway, Galway, Ireland 3 Discipline of General Practice, National University of Ireland, Galway, 1 Distillery Road, Newcastle, Galway H91 TK33, Ireland Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduct
Data Loading...
