San José State University, San Jose, California, United States of America.
The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America.
PLoS One. 2021 Jun 10;16(6):e0252888. doi: 10.1371/journal.pone.0252888. eCollection 2021.
This study aimed to begin to address this gap using validated techniques in human factors to perform a participatory user-centered analysis of physical space during emergency Cesarean.
This study employed a mixed-methods design. Focus group interviews and surveys were administered to a convenience sample (n = 34) of multidisciplinary obstetric teams. Data collected from focus group interviews were used to perform a task and equipment analysis. Survey data were coded and mapped by specialty to identify reported areas of congestion and time spent, and to identify themes related to physical space of the OR and labor and delivery unit.
Task analysis revealed complex interdependencies between specialties. Thirty task groupings requiring over 20 pieces of equipment were identified. Perceived areas of congestion and areas of time spent in the OR varied by clinical specialty. The following categories emerged as main challenges encountered during an emergency Cesarean: 1) size of physical space and equipment, 2) layout and orientation, and 3) patient transport.
User insights on physical space and workflow processes during emergency Cesarean section at the institution studied revealed challenges related to getting the patients into the OR expediently and having space to perform tasks without crowding or staff injury. By utilizing human factors techniques, other institutions may build upon our findings to improve safety during emergency situations on labor and delivery.
本研究旨在利用人为因素学中的已验证技术，对紧急剖宫产过程中的物理空间进行参与式以用户为中心的分析，从而填补这一空白。
本研究采用混合方法设计。对多学科产科团队的便利样本（n=34）进行了焦点小组访谈和调查。从焦点小组访谈中收集的数据用于进行任务和设备分析。对调查数据进行了编码，并按专业进行了映射，以确定报告的拥堵区域和时间，并确定与手术室和产房物理空间以及与时间相关的主题。
任务分析揭示了专业之间的复杂相互依存关系。确定了 30 个需要 20 多件设备的任务分组。各临床专业对手术室的拥堵区域和时间的感知存在差异。在紧急剖宫产过程中遇到的主要挑战包括：1）物理空间和设备的大小，2）布局和方向，3）患者转运。
在研究机构中对紧急剖宫产期间物理空间和工作流程的用户见解揭示了与迅速将患者送入手术室以及有足够空间进行任务而不会拥挤或造成员工受伤相关的挑战。通过利用人为因素技术，其他机构可以在我们的研究结果的基础上进一步改进分娩室紧急情况下的安全性。
