Human Factors Integration (HFI) in UK healthcare route map for 1 year, 5 years, 10 years and 20 years

This paper reflects on Human Factors Integration (HFI) to consider how Human Factors/Ergonomics has influenced Defence activities, and could influence safety and performance in Healthcare activities. A workshop with 16 Chartered Institute of Ergonomics & Human Factors members was held in July 2016 to discuss and propose a Route Map for HFI in the UK National Health Service. The results set out achievable targets for 1, 5, 10 and 20 years culminating in mandatory HFI to achieve a resilient system for safety culture and work load

Dying ‘on time’ in dementia

The fear of suffering dementia may lead to people signing an Advance Euthanasia Directive to make provision for health care decisions in the event that he/she becomes unable to make those decisions. However, Advance Euthanasia Directives are rarely adhered to in the case of dementia because the symptoms of dementia conflict with the due care criteria; a person requesting euthanasia must be able to confirm this request at time of death and must be undergoing unbearable and hopeless suffering. Once dementia has progressed, the euthanasia ‘wish’ can no longer be confirmed, and assessing suffering in a person with dementia is nearly impossible. This means that for a euthanasia request to be successful you have to perform the euthanasia early enough, while the patient is still cognitively competent. The risk in doing so is that the patient may lose years of their life that could have been full of quality. Postponing euthanasia in dementia could result in euthanasia not being possible and the person with dementia living a life that they did not want. This paper addresses how to decide what ‘on time’ is when it comes to dying with dementia through literature review, information visualisation and public debate

Provoking the debate on euthanasia in dementia with design.

Dementia affects 47 million people worldwide. It is a collection or consequence of many illnesses with symptoms including deterioration in memory, thinking and behaviour; it is a terminal disease. The fear of dementia leads people to request euthanasia. Euthanasia in dementia rarely happens because the dementia symptoms conflict with the due care criteria; a person requesting euthanasia must confirm the request at time of death and must be undergoing hopeless suffering. Once dementia has progressed, the euthanasia ‘wish’ can no longer be confirmed, and assessing suffering in a person with dementia is hard. Having a reliable dementia diagnosis is essential in order to be able to make a decision for an ‘early’ euthanasia. This paper describes a Speculative Design to explore what options should be considered for receiving a dementia diagnosis in order to plan a death. A branding strategy was developed for the Planned Death company, who advocate an early diagnosis for making end-of-life decisions. The branding includes company identity, website, diagnostic kit, diagnostic delivery strategy, and end-of-life support. Additionally a short documentary was developed describing the Planned Death Company’s motivation and a client testimonial. Responses to the documentary were collected with a carefully selected group of participants through a survey and in-depth interviews. The responses were rich and sparked debate. Many new questions arose to do with patient autonomy and social structures

A study on job postures and musculoskeletal illnesses in dentists

Objectives: Musculoskeletal disorders (MSDs) compose a large part of occupational diseases in dental professionals, prevention of which is dependent on assessment and improvement of job postures by means of ergonomic interventions. This study was aimed at evaluation of ergonomic conditions of the profession of dentists and also at assessing the relationship between MSDs and conditions of work. Materials and Methods: This cross-sectional study was performed among 65 dentists using the method of Rapid Entire Body Assessment (REBA). The prevalence of MSDs was obtained by the use of the Nordic Musculoskeletal Questionnaire (NMQ). Results: In this investigation, the prevalence of MSDs for different body parts was: 75.9% for the neck, 58.6% for the shoulders, 56.9% for the upper back, 48.3% for the lower back and 44.8% for the wrist. Job analysis by the use of REBA showed that 89.6% of limbs in group A and 79.3% of limbs in group B had a score > 4. Only neck and lower back pain have significant relationship with the risk levels obtained using the REBA method. Conclusions: It can be concluded that work postures of dentists need to be improved. In addition to education, work station design, rest period during work and regular physical activities should be taken into account

Human factors for dementia: Evidence based design

Designing care environments for people living with dementia is a complex challenge as the key stakeholder may have difficulty communicating their capabilities, limitations and preferences. This paper describes the use of evidence-based design personas in a multi-disciplinary team with architects and chartered human factors specialists. Four individual personas (Alison, Barry, Christine and David) and a couple persona (Chris and Sally) were used to bring the voices of the people living with different stages of dementia to the design process. Their changing/fluctuating symptoms were communicated in two formats (wheel and matrix) within an inclusive design process to adapt a Victorian semi-detached house. The demonstrator house presents evidence based design, adaptation and support solutions to support people living with dementia to age well at home

Applying human factors methods to explore ‘Work as Imagined’ and ‘Work as Done’ in the Emergency Department’s response to chemical, biological, radiological, and nuclear events

The Emergency Department (ED) is a complex, hectic, and high-pressured environment. Chemical, Biological, Radiological, and Nuclear (CBRN) events are multi-faceted emergencies and present numerous challenges to ED staff (first receivers) with large scale trauma, consequently requiring a combination of complex responses. Human Factors and Ergonomics (HF/E) methods such as Hierarchical Task Analysis (HTA) have been used in healthcare research. However, HF/E methods and theory have not been combined to understand how the ED responds to CBRN events. This study aimed to compare Work as Imagined (WAI) and Work as Done (WAD) in the ED CBRN response in a UK based hospital. WAI was established by carrying out document analyses on a CBRN plan and WAD by exploring first receivers response to CBRN scenario cards. The responses were converted to HTAs and compared. The WAI HTAs showed 4-8 phases of general organizational responsibilities during a CBRN event. WAD HTAs placed emphasis on diagnosing and treating presenting conditions. A comparison of WAI and WAD HTAs highlighted common actions and tasks. This study has identified three key differences between WAI and WAD in the ED CBRN response: 1) documentation of the CBRN event 2) treating the patient and 3) diagnosing the presenting complaint. Findings from this study provide an evidence base which can be used to inform future clinical policy and practice in providing safe and high quality care during CBRN events in the ED

Smart garment for trunk posture monitoring: A preliminary study

© 2008 Wong and Wong; licensee BioMed Central Ltd

Aerosol Characteristics at a High Altitude Location in Central Himalayas: Optical Properties and Radiative Forcing

Collocated measurements of the mass concentrations of aerosol black carbon (BC) and composite aerosols near the surface were carried out along with spectral aerosol optical depths (AODs) from a high altitude station, Manora Peak in Central Himalayas, during a comprehensive aerosol field campaign in December 2004. Despite being a pristine location in the Shivalik Ranges of Central Himalayas, and having a monthly mean AOD (at 500 nm) of 0.059 $\pm$ 0.033 (typical to this site), total suspended particulate (TSP) concentration was in the range 15 - 40 micro g m^(-3) (mean value 27.1 $\pm$ 8.3 micro g m^(-3)). Interestingly, aerosol BC had a mean concentration of 1.36 $\pm$ 0.99 micro g m^(-3), contributed to ~5.0 $\pm$ 1.3 % to the composite aerosol mass. This large abundance of BC is found to have linkages to the human activities in the adjoining valley and to the boundary layer dynamics. Consequently, the inferred single scattering albedo lies in the range of 0.87 to 0.94 (mean value 0.90 $\pm$ 0.03), indicating significant aerosol absorption. The estimated aerosol radiative forcing was as low as 4.2 W m^(-2) at the surface, +0.7 W m^(-2) at the top of the atmosphere, implying an atmospheric forcing of +4.9 W m^(-2). Though absolute value of the atmospheric forcing is quite small, which arises primarily from the very low AOD (or the column abundance of aerosols), the forcing efficiency (forcing per unit optical depth) was $\sim$88 W m^(-2), which is attributed to the high BC mass fraction.Comment: 32 Pages, Accepted in JGR (Atmosphere

Life values as predictors of pain, disability and sick leave among Swedish registered nurses: a longitudinal study

<p>Abstract</p> <p>Background</p> <p>Prospective studies on high-risk populations, such as subgroups of health care staff, are limited, especially prospective studies among staff not on sick-leave. This paper is a report of a longitudinal study conducted to describe and compare the importance and consistency of life domains among registered nurses (RNs) working in a Swedish hospital and evaluate a model based on the consistency of valued life domains for prediction of pain, disability and sick leave.</p> <p>Method</p> <p>Importance and consistency ratings of life values, in 9 domains, were collected during 2003 and 2006 from 196 RNs using the Valued Living Questionnaire (VLQ). Logistic regression analyses were used for prediction of pain, disability and sick leave at the three-year follow-up. The predictors family relations, marriage couples/intimate relations, parenting, friends/social life, work, education, leisure time, psychological well-being, and physical self-care were used at baseline.</p> <p>Results</p> <p>RNs rated life values regarding parenting as most important and with the highest consistency both at baseline and at follow-up. No significant differences were found between RNs' ratings of importance and consistency over the three-year period, except for friends/social relations that revealed a significant decrease in importance at follow-up. The explanatory models for pain, disability and sick leave significantly predicted pain and disability at follow-up. The odds of having pain were significantly increased by one consistency rating (psychological well-being), while the odds were significantly decreased by physical self-care. In the model predicting disability, consistency in psychological well-being and education significantly increased the odds of being disabled, while consistency in physical self-care significantly decreased the odds.</p> <p>Conclusion</p> <p>The results suggest that there might be a link between intra-individual factors reflecting different aspects of appraised life values and musculoskeletal pain (MSP).</p