Smart agent system for insulin infusion protocol management: a simulation-based human factors evaluation study.
Smart agent system for insulin infusion protocol management: a simulation-based human factors evaluation study.
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DOI：
10.1136/bmjqs-2020-011420
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发表时间：
2021-11
影响因子：
5.4
通讯作者：
Sapirstein A
中科院分区：
文献类型：
--
作者：
Rosen MA;Romig M;Demko Z;Barasch N;Dwyer C;Pronovost PJ;Sapirstein A
比较护士使用通用标准（即人工完成胰岛素输注方案步骤）或智能代理（SA）系统（集成电子健康记录和输注泵并自动选择胰岛素剂量）对危重患者进行胰岛素输注管理。一个受试者内设计，参与者完成了12个模拟场景，在4个区块的3个场景。使用手动标准品或SA系统进行每个区组。初始起始条件随机分配至手动标准或SA，此后交替。在大型学术医疗中心进行的基于模拟的人为因素评估。20名重症监护护士胰岛素输注管理的系统工程干预，SA。主要研究结果是错误率和任务完成时间。次要研究结果是感知工作量，信任自动化和系统可用性，所有测量与以前验证的规模。与手动计算相比，SA系统产生的剂量误差显著更少（17%（n=20）vs 0，p<0.001）。参与者明显更快，使用SA系统完成协议（p<0.001）。SA系统的总体工作负荷评分显著低于手动系统（p<0.001）。对于信任度，时间（第一次或第二次曝光）和所使用的系统之间存在显着的相互作用，因此，在第二次曝光两个系统后，参与者对SA系统的信任度显着增加。参与者对SA系统可用性的评价显著高于手动系统（p<0.001）。系统工程方法共同优化了安全、效率和工作量考虑因素。
To compare the insulin infusion management of critically ill patients by nurses using either a common standard (ie, human completion of insulin infusion protocol steps) or smart agent (SA) system that integrates the electronic health record and infusion pump and automates insulin dose selection. A within subjects design where participants completed 12 simulation scenarios, in 4 blocks of 3 scenarios each. Each block was performed with either the manual standard or the SA system. The initial starting condition was randomised to manual standard or SA and alternated thereafter. A simulation-based human factors evaluation conducted at a large academic medical centre. Twenty critical care nurses. A systems engineering intervention, the SA, for insulin infusion management. The primary study outcomes were error rates and task completion times. Secondary study outcomes were perceived workload, trust in automation and system usability, all measured with previously validated scales. The SA system produced significantly fewer dose errors compared with manual calculation (17% (n=20) vs 0, p<0.001). Participants were significantly faster, completing the protocol using the SA system (p<0.001). Overall ratings of workload for the SA system were significantly lower than with the manual system (p<0.001). For trust ratings, there was a significant interaction between time (first or second exposure) and the system used, such that after their second exposure to the two systems, participants had significantly more trust in the SA system. Participants rated the usability of the SA system significantly higher than the manual system (p<0.001). A systems engineering approach jointly optimised safety, efficiency and workload considerations.
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影响因子：
3.2
作者：
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通讯作者：
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通讯作者：
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作者：
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