HFE can be applied to help to design technologies that facilitate IP & C , to help develop or streamline processes that support IP & C , and to improve training so people can more effectively apply IP & C best practices .”
— Patrice D . Tremoulet , PhD
individual factors ( people ), tasks , technologies / tools , the organization , and the environment . Additional elements outside of healthcare settings affect healthcare delivery and include insurance reimbursement policies and regulatory and legal contexts .”
Regarding how to best employ HFE , Tremoulet advises , “ Evaluating the effectiveness , ease of use , and user satisfaction of various products that are designed to support IP & C is generally easier than designing new training programs or developing new procedures , which really should be done in conjunction with simulations to understand how they may interact with features of the work environment and existing processes .”
Tremoulet continues , “ Benefits can be significant when human factors engineers are given full access to the environment for observations and the ability to interview clinicians about what was observed ; the challenge can be obtaining access and being able to spend enough time in those environments to develop a full understanding of the users , environment , processes and tools , all of which is needed to develop beneficial solutions .”
Jacob , Herwaldt , and Durso ( 2018 ) point out that HFE has seen limited application in addressing IP & C-related these challenges to date , but that HFE can serve the infection control segment well : “ Cross-contamination and the existence of workarounds suggest that healthcare workers need better support to reduce and simplify steps in delivering care . Simplifying workflow can lead to better understanding of why a process fails and allow for improvements to reduce errors and increase efficiency . Hand hygiene can be improved using visual cues and nudges based on room layout . Using personal protective equipment appropriately appears simple , but exists in a complex interaction with workload , behavior , emotion , and environmental variables including product placement . HFE can help prevent the pathogen transmission through improving environmental cleaning and appropriate use of medical devices .”
Pennathur and Herwaldt ( 2017 ) reviewed the literature on HFE and infection prevention and control and identified major themes to document how researchers and infection prevention staff have used HFE methods to prevent HAIs and to identify gaps in knowledge about the role of HFE in HAI prevention and control . They found that most studies in the healthcare domain explicitly applying HFE principles and methods addressed patient safety issues not infection prevention and control issues . In addition , most investigators who applied human factors principles and methods to infection prevention issues assessed only one human factors element such as training , technology evaluations , or physical environment design . The most significant gap pertains to the limited use and application of formal HFE tools and methods . Every infection prevention study need not assess all components in a system , but investigators must assess the interaction of critical system components if they want to address latent and deep-rooted human factors problems .
Pennathur and Herwaldt ( 2017 ) emphasize that , “ To prevent healthcare-associated infections ( HAIs ), infection prevention and control staff and other healthcare workers must systematically identify , analyze , and evaluate factors associated with HAIs , and how these factors interact .” These factors include :
● people , both patients , and healthcare workers
● medical devices , tools , and technologies
● personal protective equipment used by healthcare workers
● the physical environment
● infection prevention and control guidelines , policies , and procedures
HFE can make significant contributions to improve hand hygiene , personal protective equipment and central line related activities . Let us explore each area that can be impacted by HFE .
HFE and Hand Hygiene
Drews , et al . ( 2020 ) acknowledge that “ Hand hygiene is located at the interface between human behavior and technology ( e . g ., dispensers ) and HFE can contribute the theoretical depth and practical knowledge necessary for developing interventions .”
They add , “ One perspective to explain low hand hygiene adherence is to view it as an issue of training deficits . However , although training deficits are part of a comprehensive explanation for nonadherence , a socio-technical systems perspective may provide alternative explanations and help develop successful and sustainable interventions . For example , Sax and Clack ( 2015 ) argue that inaccurate mental models may lead to breakdowns in hand hygiene and that experience and alignment of the models with the workplace may lead to their optimization . Thus , HFE-based workplace modification that increases hand hygiene saliency — such as purposeful placement of hand sanitizer dispensers in convenient , noticeable locations — may increase adherence .”
The built environment can influence healthcare professionals ’ habits and compliance . Elsewhere in the medical literature , Cure and Van Enk ( 2015 ) examined the effect of hand sanitizer dispenser usability on hand hygiene adherence and found that that dispenser visibility and proximity to entrance increased adherence , whereas standardization did not . Usability included visibility and proximity to room entrance and point of care , easy and unobstructed access , location along the physical workflow path , and dispenser installation height . Patterson , et al . ( 2014 ) identified issues preventing hand hygiene adherence , including inconsistent location of hand sanitizer dispensers , separation of the glove storage location from the hand sanitizer dispenser and sink use for storage , rendering it unusable for handwashing .
Pennathur and Herwaldt ( 2017 ) observe that , “ Healthcare workers and companies that make hand hygiene dispensers might avoid the problems