College of Health, Psychology and Social Care, University of Derby, Derby, UK; TRL, Wokingham, UK.
College of Health, Psychology and Social Care, University of Derby, Derby, UK.
Br J Anaesth. 2023 Mar;130(3):343-350. doi: 10.1016/j.bja.2022.11.012. Epub 2023 Jan 10.
Anaesthetic procedures are complex and subject to human error. Interventions to alleviate medication errors include organised syringe storage trays, but no standardised methods for drug storage have yet been widely implemented.
We used experimental psychology methods to explore the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a visual search task. We hypothesised that colour-coded compartmentalised trays would reduce search time and improve error detection for both behavioural and eye-movement responses. We recruited 40 volunteers to identify syringe errors presented in pre-loaded trays for 16 trials in total: 12 error present and four error absent, with eight trials presented for each tray type.
Errors were detected faster when presented in the colour-coded compartmentalised trays than in conventional trays (11.1 s vs 13.0 s, respectively; P=0.026). This finding was replicated for correct responses for error-absent trays (13.3 s vs 17.4 s, respectively; P=0.001) and in the verification time of error-absent trays (13.1 s vs 17.2 s, respectively; P=0.001). On error trials, eye-tracking measures revealed more fixations on the drug error for colour-coded compartmentalised trays (5.3 vs 4.3, respectively; P<0.001), whilst more fixations on the drug lists for conventional trays (8.3 vs 7.1, respectively; P=0.010). On error-absent trials, participants spent longer fixating on the conventional trials (7.2 s vs 5.6 s, respectively; P=0.002).
Colour-coded compartmentalisation enhanced visual search efficacy of pre-loaded trays. Reduced fixations and fixation times for the loaded tray were shown for colour-coded compartmentalised trays, indicating a reduction in cognitive load. Overall, colour-coded compartmentalised trays were associated with significant performance improvements when compared with conventional trays.
麻醉程序复杂，容易出现人为错误。为了减轻用药错误，已经采取了一些干预措施，包括组织注射器储存托盘，但目前尚未广泛采用标准化的药物储存方法。
我们使用实验心理学方法，在视觉搜索任务中探索了彩色分隔托盘与传统托盘相比的潜在优势。我们假设，彩色分隔托盘可以减少搜索时间，并提高行为和眼动反应的错误检测。我们招募了 40 名志愿者，总共完成了 16 次试验，识别预加载托盘内的注射器错误：12 次出现错误，4 次未出现错误，每种托盘类型各有 8 次试验。
与传统托盘相比，在彩色分隔托盘上呈现错误时，错误被检测到的速度更快（分别为 11.1 秒和 13.0 秒，P=0.026）。对于无错误托盘的正确反应，也得到了相同的结果（分别为 13.3 秒和 17.4 秒，P=0.001），以及无错误托盘的验证时间（分别为 13.1 秒和 17.2 秒，P=0.001）。在错误试验中，眼动跟踪测量显示，彩色分隔托盘上药物错误的注视点更多（分别为 5.3 次和 4.3 次，P<0.001），而传统托盘上药物清单的注视点更多（分别为 8.3 次和 7.1 次，P=0.010）。在无错误试验中，参与者在传统托盘上的注视时间更长（分别为 7.2 秒和 5.6 秒，P=0.002）。
彩色分隔增强了预加载托盘的视觉搜索效果。与传统托盘相比，彩色分隔托盘的加载托盘注视点和注视时间减少，表明认知负荷降低。总体而言，与传统托盘相比，彩色分隔托盘的性能有显著提高。
