University Accident Research Centre, Monash University, Melbourne, Victoria, Australia.
Department of Anaesthesia and Peri-operative Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Anaesthesia. 2018 Aug;73(8):980-989. doi: 10.1111/anae.14302. Epub 2018 Apr 16.
Human factors are the individual, team, environmental and organisational aspects of the anaesthetic environment that affect performance and decision-making of anaesthesia teams. This study aimed to identify which human factors were enablers and/or barriers to anaesthesia teams during airway management challenges. Sixteen interviews were conducted with experienced anaesthetists and anaesthetic nurses using an in-depth interview technique (the Critical Decision Method) to identify human factors enablers and/or barriers during successful management of a significant airway challenge. Thematic analysis identified three overarching enablers: equipment location and storage; experience and learning; teamwork and communication. Five overarching barriers were also identified: time and resource limitations; teamwork and communication; equipment location and storage; experience and learning; insufficient back-up planning; and equipment preparation. This study showed that a variety of human factors issues affect the handling of airway challenges, ranging from individual and team to organisational and environmental aspects. Recommendations for the design of airway management decision support tools that relate to equipment standardisation, decision support complexity, inclusive mutual learning and teamwork are discussed.
人为因素是麻醉环境中影响麻醉团队绩效和决策的个体、团队、环境和组织方面。本研究旨在确定在气道管理挑战期间，哪些人为因素对麻醉团队是有利的和/或有阻碍的。通过深入访谈技术（关键决策方法）对有经验的麻醉师和麻醉护士进行了 16 次访谈，以确定在成功管理重大气道挑战期间的人为因素促进因素和/或障碍。主题分析确定了三个总体促进因素：设备位置和存储；经验和学习；团队合作和沟通。还确定了五个总体障碍：时间和资源限制；团队合作和沟通；设备位置和存储；经验和学习；备用计划不足；以及设备准备。本研究表明，各种人为因素问题影响气道挑战的处理，从个人和团队到组织和环境方面都有涉及。讨论了与设备标准化、决策支持复杂性、包容性共同学习和团队合作相关的气道管理决策支持工具设计的建议。
