Connecting pathogen transmission and healthcare worker cognition: a cognitive task analysis of infection prevention and control practices during simulated patient care.
Background Relatively little is known about the cognitive processes of healthcare workers that mediate between performance-shaping factors (eg, workload, time pressure) and adherence to infection prevention and control (IPC) practices. We taxonomised the cognitive work involved in IPC practices and...
| Published in: | BMJ Quality & Safety Vol. 33; no. 7; pp. 419 - 438 |
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| Main Authors: | , , , , , , , , , |
| Format: | glossary pictorial research tables/charts Journal Article |
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BMJ Publishing Group
Jul2024
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178602253&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178602253 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20445415 BFNQ jtl: BMJ Quality & Safety issn: 20445415 maglogo: N pubinfo: dt: Jul2024 vid: 33 iid: 7 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 178602253 178602253 178602253 10.1136/bmjqs-2023-016230 178602253 ppf: 419 ppct: 19 formats: tig: atl: Connecting pathogen transmission and healthcare worker cognition: a cognitive task analysis of infection prevention and control practices during simulated patient care. aug: au: Mumma, Joel M. Weaver, Bradley W. Morgan, Jill S. Ghassemian, Golpar Gannon, Paige R. Burke, Kylie B. Berryhill, Brandon A. MacKay, Rebecca E. Lee, Lindsay Kraft, Colleen S. affil: Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA sug: subj: Infection Control Cross Infection Prevention and Control Cognition Patient Simulation Nursing Care Human Male Female Registered Nurses Nursing Staff, Hospital Descriptive Statistics Comparative Studies Patient Care Funding Source Task Performance and Analysis Workflow Workload Male Female ab: Background Relatively little is known about the cognitive processes of healthcare workers that mediate between performance-shaping factors (eg, workload, time pressure) and adherence to infection prevention and control (IPC) practices. We taxonomised the cognitive work involved in IPC practices and assessed its role in how pathogens spread. Methods Forty-two registered nurses performed patient care tasks in a standardised high-fidelity simulation. Afterwards, participants watched a video of their simulation and described what they were thinking, which we analysed to obtain frequencies of macrocognitive functions (MCFs) in the context of different IPC practices. Performance in the simulation was the frequency at which participants spread harmless surrogates for pathogens (bacteriophages). Using a tertiary split, participants were categorised into a performance group: high, medium or low. To identify associations between the three variables--performance groups, MCFs and IPC practices--we used multiblock discriminant correspondence analysis (MUDICA). Results MUDICA extracted two factors discriminating between performance groups. Factor 1 captured differences between high and medium performers. High performers monitored the situation for contamination events and mitigated risks by applying formal and informal rules or managing their uncertainty, particularly for sterile technique and cleaning. Medium performers engaged more in future-oriented cognition, anticipating contamination events and planning their workflow, across many IPC practices. Factor 2 distinguished the low performers from the medium and high performers who mitigated risks with informal rules and sacrificed IPC practices when managing trade-offs, all in the context of minimising cross-contamination from physical touch. Conclusions To reduce pathogen transmission, new approaches to training IPC (eg, cognitive skills training) and system design are needed. Interventions should help nurses apply their knowledge of IPC fluidly during patient care, prioritising and monitoring situations for risks and deciding how to mitigate risks. Planning IPC into one's workflow is beneficial but may not account for the unpredictability of patient care. pubtype: Academic Journal doctype: glossary pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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