Decisions about critical events in device-related scenarios as a function of expertise.
Decisions about critical events in device-related scenarios as a function of expertise.
复制标题
根据专业知识做出有关设备相关场景中的关键事件的决策。
DOI：
10.1016/j.jbi.2004.11.012
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Patel,VimlaL
中科院分区：
文献类型：
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作者：
Laxmisan,Archana;Malhotra,Sameer;Keselman,Alla;Johnson,ToddR;Patel,VimlaL
本文介绍了参与决策的人员在重症监护设备的观点。我们使用实践的“尖锐和钝端”的概念来描述医疗保健专业人员的表现。“尖端”在物理上和时间上靠近系统;“钝端”在时间和空间上远离系统，但通过对尖端的间接影响来影响系统。在这项研究中，尖锐的一端是由临床医生（护士和医生）和钝端的管理人员和生物医学工程师。这些主题代表了参与为医院购买生物医学设备的决策过程的专业人员。他们被要求“大声思考”，同时根据真实的事件评估三个错误场景。这些回答被记录下来并转录下来进行分析。结果表明，在解释的关键事件作为专业知识的功能的差异。临床医生（尖端从业者）专注于临床和人为方面的错误，而生物医学工程师专注于设备相关的错误。行政人员的重点是文件和培训。这些不同的解释意味着，这些问题是由这些群体的主题不同的代表，这些代表性的结果在可变的决定有关的设备。这些结果进行了讨论，在一个系统的方法框架内，以帮助我们评估的完整性的问题表示的主题，他们的意识的关键事件，以及这些事件将如何共同有助于错误的发生。
This paper presents the perspectives of personnel involved in decision-making about devices in critical care. We use the concept of “sharp and blunt ends” of practice to describe the performance of health care professionals. The “sharp end” is physically and temporally close to the system; the “blunt end” is removed from the system in time and space and yet affects the system through indirect influence on the sharp end. In this study, the sharp end is represented by the clinicians (nurses and doctors) and the blunt end by the administrators and biomedical engineers. These subjects represent the professionals involved in the decision-making process for purchasing biomedical equipment for the hospital. They were asked to “think aloud” while evaluating three error scenarios based on real events. The responses were recorded and transcribed for analysis. The results show differences in interpretation of critical events as a function of professional expertise. The clinicians (sharp-end practitioners) focused on clinical and human aspect of errors while the biomedical engineers focused on device-related errors. The administrators focused on documentation and training. These different interpretations mean that the problems are represented differently by these groups of subjects, and these representations result in variable decisions about devices. These results are discussed within a systems approach framework to help us assess the completeness of the problem representations of the subjects, their awareness of critical events, and how these events would collectively contribute to the occurrence of error.