Using human factors engineering to improve patient safety in the cardiovascular operating room

Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. The purpose of this study was to identify and categorize hazards (anything that has the potential to cause a preventable adverse patient safety event) in the CVOR. An interdisciplinary research team used prospective hazard identification methods including direct observations, contextual inquiry, and photographing to collect data in 5 hospitals for a total 22 cardiac surgeries. We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.     

The effect of neighborhood on crime and safety: a review of the evidence

There is a growing, multidisciplinary body of evidence on the effects that neighborhoods have on family outcomes. This evidence is important for social workers as we work with clients and communities from a person-in-environment perspective. In this article the authors present findings from a systematic, integrative review of neighborhood effects specifically for crime and safety. Thirty-seven research studies using random samples from urban, U.S. areas between 2002 and 2008 are reviewed. Findings suggest socio-demographic characteristics of neighborhoods and neighborhood processes are both predictive of crime and safety. Further, some neighborhood conditions may affect crime and safety in unexpected ways. Implications for social work practice, neighborhood interventions, and evidence-based practice are discussed.     

Sociotechnical systems approach to healthcare quality and patient safety

The SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety is described and selected research and practical applications are presented.     

Handover process: how to improve quality and safety through an ergonomic solution

Patient safety practices for enhancing the quality and safety of handover are context sensitive interventions. In this article we explore the use of cultural probes as a qualitative technique with a twofold objective: eliciting implicit activity pattern and tools that may constitute resources for the design of effective handover solutions and prompting health care practitioners' participation and involvement.     

Online programs as tools to improve parenting: A meta-analytic review

Background

A number of parenting programs, aimed at improving parenting competencies, have recently been adapted or designed with the use of online technologies. Although web-based services have been claimed to hold promise for parent support, a meta-analytic review of online parenting interventions is lacking.

Method

A systematic review was undertaken of studies (n = 19), published between 2000 and 2010, that describe parenting programs of which the primary components were delivered online. Seven programs were adaptations of traditional, mostly evidence-based, parenting interventions, using the unique opportunities of internet technology. Twelve studies (with in total 54 outcomes, N_tot parents = 1615 and N_tot children = 740) were included in a meta-analysis.

Results

The meta-analysis showed a statistically significant medium effect across parents outcomes (ES = 0.67; se = 0.25) and child outcomes (ES = 0.42; se = 0.15).

Conclusions

The results of this review show that web-based parenting programs with new technologies offer opportunities for sharing social support, consulting professionals and training parental competencies. The meta-analytic results show that guided and self-guided online interventions can make a significant positive contribution for parents and children. The relation with other meta-analyses in the domains of parent education and web-based interventions is discussed.     

Pre-commitment in gambling: a review of the empirical evidence

Norway, a Canadian province and Australia have introduced, or are considering introducing, voluntary or mandatory pre-commitment systems for electronic gaming machines. This paper critically reviews the empirical literature evaluating the effectiveness of such systems as a responsible gambling strategy. A literature search identified 17 relevant peer- and non-peer-reviewed publications. Self-report data suggests the majority of gamblers are positively predisposed to the concept of pre-commitment but non-problem and low-risk gamblers regard the system as personally unnecessary. Overall, studies reported variable findings relating to adherence to money limits and expenditure. Few gamblers appear to use options to set time limits. Methodological flaws such as low participation rates, compromised data integrity resulting from card sharing and failure to control for concurrent gambling outside trials limit conclusions drawn regarding the effectiveness of pre-commitment. It is recommended that further systematic trials should be implemented to determine the impact of pre-commitment systems on gamblers' behaviour.     

Occupational health and safety professionals strategies to improve working environment and their self-assessed impact

Research suggests that Occupational Health and Safety (OHS) practitioners have difficulty influencing the decision-making process because they are placed on the sidelines in the organisation. This paper analyses the strategies that OHS practitioners use to fulfill their job role and the impact they have on the working environment and OHS management systems. Semi-structured interviews were conducted with ten New Zealand OHS practitioners from mainly large private and public organisations about their job role, OHS tasks, strategies and their impact. The interviews were tape recorded, transcribed, entered into a qualitative data management programme and analysed thematically in relation to their strategies, barriers and their impact on the OHS management system and working environment. The analysis revealed that these OHS practitioners used multiple strategies - chosen in relation to the situation, the stakeholders and their own resources. They saw themselves as change agents or facilitators. They preferred to use a knowledge strategy, supported by an audit strategy. Their last resort was a regulation strategy. All of the practitioners had a positive impact on stakeholders' knowledge, attitude and behavior and on OHS management systems. Some practitioners improved the working environment but few were involved in introduction of new technology.     

The acceptability of educational Interventions: Qualitative evidence from children and young people in care

There has been a proliferation of educational interventions that aim to address the disadvantage experienced by children and young people in care. However, the existing evidence-base has been limited by a dearth of theoretically-driven approaches and the inadequate involvement of the target population in developing interventions' theory of change or delivery mechanisms. The present study reports data from focus groups with care-experienced young people (n = 26) aged 16–27 regarding the acceptability of educational interventions that have already been developed and subjected to evaluation via a randomized controlled trial. Although participants highlighted the merit of interventions that address social and emotional competencies, and have a clear relational component, they primarily felt that existing approaches fail to address the structural barriers to academic attainment. These include placement instability, inadequate resources, and lack of time and skills amongst carers. Participants indicated a preference for interventions delivered by carers. They equally suggested a preference for approaches that are universal rather than indicated. The variation in acceptability across interventions, both in terms of theory of change and delivery mechanisms, indicates the need to involve children and young people in the development of interventions intended to address their educational outcomes. Further theoretical, methodological and substantive research needs to be conducted in order to further enhance this process of involvement.     

Interventions for youth aging out of care: A scoping review

Youth aging out the child welfare system are being transitioned out of the child welfare system with few interventions in place to support their move to independence. In developed countries, compared to their peers, youth aging out of care face poorer outcomes when it comes to education, employment, and housing. A better understanding of the effectiveness of the existing interventions that support youth in care is warranted. This paper presents a critical scoping review of the available evidence on interventions available to youth who are aging out of the child welfare system and identifies gaps for future research. Arksey and O'Malley's framework for scoping reviews shaped the process of this review. A total of thirteen databases were searched resulting in the retrieval of 1978 articles. Of the 1978 retrieved, only 68 met the review's criteria. Studies included were in English, described an intervention that was implemented and evaluated in developed countries, and published within the last 20 years. Interventions were categorized as: housing, employment, education, mentorship, independent living, and health. The majority of studies fell under the independent living category which provide cohesive resources to improve education, housing, and employment. Studies evaluating these programs generally reported positive outcomes on youth's ability to complete their education and attain part- or full-time employment. Methods of evaluations were found to be methodologically weak with respect to determining the effectiveness of interventions in ensuring youth's successful transitions to independence. Future research should look at longitudinal outcomes of youth and cost-benefit analysis of supporting youth transitioning out of the child welfare system. Recommendations also include policy changes extending the age of eligibility for youth transitioning out of the child welfare system.     

A systematic review of interventions to improve post-secondary educational outcomes among foster care alumni

In their transition to adulthood, youth who have aged out of foster care struggle in a variety of areas. One area of concern is achieving success in post-secondary education. In response, universities and community colleges around the country offer support programs for these youth, in order to assist them in gaining a college education. The purpose of this study was to utilize a systematic review process to uncover the current status of what is known about campus support programs for foster care alumni in two areas—student views of their program experiences and outcomes of interventions to improve post-secondary educational success. We adapted the Participants, Interventions, Comparison groups, Outcomes, and Study designs (PICOS) model in conducting the systematic review. A search of six electronic databases and other gray literature sources yielded seven articles. Results revealed valuable insight from students regarding the ways in which program implementation was beneficial, and highlighted important strategies future programs should consider. Further, findings of outcome studies are favorable. However, additional outcome evaluations are needed in order to validate and confirm their impact.     

Interventions to Strengthen Noncustodial Father Involvement in the Lives of Their Children

Abstract

This paper describes quantitative evaluation of a program designed to increase noncustodial fathers' visitation frequency and financial assistance to their children. The initial program objectives were to enhance parental skills and work opportunities for fathers. Discussion group data revealed that additional obstacles to father involvement included conflicts between parents and substance misuse and abuse. Communication skills, anger management, alternative methods of coping with stress and increased activities for families were added to the program components in response to these needs. Future plans for strengthening community connections to expand educational, training and employment opportunities as well as increased outreach to families were based on additional assessment of interventions needed for successful co-parenthood.     

From Talk to Action: Experiencing Interlocution in Developmental Interventions

This article explores how to analyze and conceptualize the dynamics through which conversations in Change Laboratory research interventions lead to envisioning and implementing material changes in activities. Leont'ev's concept of personal sense is used as a theoretical lens for tracing these dynamics and to provide a means to relate local conversations to overall transformation of professional practices. In addition, the article tests the potential of Vasilyuk's theory of experiencing and Trognon's interlocutionary logic for analyzing Change Laboratory conversations from the point of view of how talk is experienced by the interlocutors. Experiencing is seen as a dialogical process that connects ongoing conversations and future-oriented actions, and through which interlocutors overcome critical situations. The analysis of Change Laboratory discussions in a Finnish middle school provides ground for looking at Change Laboratory as a research setting and a practice of intervention which can enrich our understanding of how change unfolds through discourse. The article concludes that interventions such as Change Laboratory could benefit from identifying systematic procedures for facilitating experiencing and interlocution. Within the perspective of seeking such methodological procedures, the article opens up a discussion on complementarities and possibilities of integration between the Change Laboratory and another interventionist approach called the Clinic of Activity.     

The use software ERGOSHOW in the education of health and safety at work to regardin the safety to children

It is believed that health and safety of workers should be worked with children and early teenagers, the perspective that adults are more aware of these issues by providing them with health and quality of life in their daily lives, this is want the ERGOSHOW. The choice of media means for transmitting content of Ergonomics, Health and Safety (OSH) is justified because of the great popularity of computer games are among the public of the study, thereby providing a greater assimilation of the content worked. Therefore, the aim of this study was to work with OSH issues related to children between 08 and 12 years old, city of, State of Minas Gerais, Brazil. To achieve this we used the software ERGOSHOW, quizzes, and lecture. One can see that the use of multimedia tools in the learning, especially when considering the reports of mothers according to the different behavior of children after the development of activities, such as parents in correcting posture in relation to computer use.     

Stage-Based Computer-Delivered Interventions to Increase Condom Use in Young Men

ABSTRACT

Objectives: The aim is to examine whether adopting or increasing condom use can be influenced by psychological treatment targeting both motivational and volitional aspects, when these components are matched to the characteristics of the recipients. Method: In a randomized controlled trial, 159 heterosexual young men (intervention groups, n = 113; control condition, n = 46) were exposed to 2 computer-delivered intervention arms, 1 targeting nonintenders (n = 36; motivational intervention arm) and the other targeting intenders (n = 77; volitional intervention arm). Intention and condom use were assessed through self-report questions at 3 points in time, each 2 weeks apart. Motivational intervention involved screen content requesting decisional balance for condom use and focus on past success to trigger self-efficacy. Volitional intervention encouraged the formation of specific if-then plans, where participants were required to choose and write about the most favourable situations by means of reflection on when, where, and how to carry them out, and of thinking about strategies for obstacles that might hinder condom use. Results: Experimental nonintenders obtained higher levels of condom use intention two weeks and one month later and of reported condom use one month later than control nonintenders. Experimental intenders reported an increase in condom use in comparison with control intenders one month later. Conclusions: At a 30-day follow-up, treatment was shown to have helped nonintenders to first increase their condom use intentions and later condom use, and intenders to improve condom use behavior. A stage-based computer-delivered intervention design including motivational and volitional treatment appears to be suitable for improving condom use motivation as well as behavior after a 1-month period.     

Nonverbal communication of pharmacists during counseling leading to patient satisfaction: evidence from Iranian retail market

The purpose of this study was to investigate the impact of nonverbal communication of community pharmacists on patients’ satisfaction throughout the counseling process. Eight dimensions of nonverbal communication have been taken into account: vocalics, kinesics, proxemics, haptics, oculesics, olfactics, chronemics, and atmospherics. To gather data relevant to the aim of this study, a survey was conducted among the pharmacies in the city of Tehran (Iran). A questionnaire was offered to patients waiting to receive their medicine asking them about the nonverbal communication of the pharmacists and the degree of their satisfaction of service encounters. Proposed hypotheses were tested with a structural equation modeling approach using the Smart PLS software package. The results strongly support the theoretical model and suggest that there is a significant correlation between all components of nonverbal communication (excluding proxemics and haptics) and consumers’ satisfaction. The originality of this article is that it is the first empirical research to evaluate all aspects of the nonverbal cues of pharmacists and their effects on patient satisfaction. Considering the relatively high growth rate of the Iran retail market, this study has profound implications for academia and the practice of pharmacy.     

Prevention programmes for youth gambling: a review of the empirical evidence

This paper critically reviews the existing literature on the effectiveness of gambling prevention programmes for youth. Two categories of preventive strategies, all universal and most school-based, are presented: gambling-specific prevention programmes and gambling and related skills workshops. The age of the participants across the different studies varied from 9 to 20 years. Results show that programmes in both categories are generally effective in reducing misconceptions and increasing knowledge about gambling. However, a lack of long-term follow-ups and of behavioural measures makes it difficult to draw any clear conclusions about the effectiveness of such programmes. Recommendations are presented to improve the development and evaluation of future prevention programmes for youth gambling.