Beverley Norris

Filling 'gaps' in strength data for design.

Data on the physical strength capabilities of users are fundamental to the safe and usable design of products. It is recognised, however, that there are many gaps in the ergonomics data available to designers. Whilst considerable research on human capabilities and limitations has already been carried out, few data exist which are directly applicable in the design process. This paper describes a two-stage research project which was undertaken to try to address some of these data gaps. Potential needs for design-relevant data were identified in Stage 1 of the research and in Stage 2 new data were collected to meet some of those needs. Data were collected on children through to the older adult on a series of six strength measurements, all of which were intended to be directly applicable to design: (1) finger push strength, (2) pinch-pull strength, (3) hand grip strength, (4) wrist-twisting strength, (5) opening strength, and (6) push and pull strength. The methodology, findings and data from this research are presented and discussed.

Capturing User Requirements in Medical Device Development: The Role of Ergonomics

Measuring and fulfilling user requirements during medical device development will result in successful products that improve patient safety, improve device effectiveness and reduce product recalls and modifications. Medical device users are an extremely heterogeneous group and for any one device the users may include patients and their carers as well as various healthcare professionals. There are a number of factors that make capturing user requirements for medical device development challenging including the ethical and research governance involved with studying users as well as the inevitable time and financial constraints. Most ergonomics research methods have been developed in response to such practical constraints and a number of these have potential for medical device development. Some are suitable for specific points in the device cycle such as contextual inquiry and ethnography. Others, such as usability tests and focus groups, may be used throughout development. When designing user research there are a number of factors that may affect the quality of data collected, including the sample of users studied, the use of proxies instead of real end-users and the context in which the research is performed. As different methods are effective in identifying different types of data, ideally more than one method should be used at each point in development. However, financial and time factors may often constrain this.

Multidisciplinary Obstetric Simulated Emergency Scenarios (MOSES): Promoting Patient Safety in Obstetrics with Teamwork-Focused Interprofessional Simulations

Introduction: We describe an example of simulation‐based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined. Methods: Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e‐mail interviews with MOSES course participants and facilitators were conducted, and video‐recorded debriefings that formed integral parts of this 1‐day course were analyzed. Results: The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training. Discussion: Interprofessional, team‐based simulations promote new learning.

Safety pictograms: are they getting the message across?

This study set out to investigate the role of pictograms in conveying consumer safety information. The experimental work was carried out in two parts. The first part investigated UK comprehension levels of 13 product related pictograms. A new method of judging levels of comprehension of the pictograms was developed. In general the pictograms surveyed were found to be poorly understood, particularly those which were abstract in nature. The second part of the research investigated the effect of different warning styles on noticeability and intended compliance. This was tested using the new European Standard pictogram developed to convey the small parts warning on toys. The effect on parents intended purchase decisions of different pictograms and or text messages was investigated. Results indicated that parents decisions on toy suitability were influenced by the perceived hazardousness of the product rather than warnings, regardless of their design. The paper discusses the advantages and limitations of pictograms as a method for conveying consumer information and makes recommendations for their effective use.

A naturalistic study of railway controllers

There is an increasing prevalence for work to be analysed through naturalistic study, especially using ethnographically derived methods of enquiry and qualitative field research. The relatively unexplored domain of railway control (in comparison to signalling) in the UK is described in terms of features derived from observations and semi-structured interviews. In addition, task diagrams (a technique taken from the Applied Cognitive Task Analysis toolkit) are used to represent controllers core elements of work, i.e. to manage events or incidents, and to identify the challenging steps in the process. The work features identified, the task diagrams, and the steps identified as challenging form a basis from which future ergonomics studies on railway controllers in the UK will be carried out.

Human factors and safe patient care

AIMSnThis paper aims to introduce the topic of human factors to nursing management and to identify areas where it can be applied to patient safety.nnnBACKGROUNDnHuman factors is a discipline established in most safety critical industries and uses knowledge about human behaviour in the analysis and design of complex systems, yet it is relatively new to many in healthcare.nnnEVALUATIONnMost safety critical industries have developed tools and techniques to apply human factors to system design, and these have been reviewed together with those resources already available for use in healthcare.nnnKEY ISSUESnModels of human behaviour such as the nature and patterns of human error, information processing, decision-making and team work have clear applications to healthcare. Human factors focus on a system view of safety, and propose that safety should, where possible, be designed in. Other interventions such as building defences, mitigating hazards and education and training should only be used where design solutions cannot be found.nnnCONCLUSIONSnSimple human factors principles such as: designing for standardization; the involvement of users and staff in designing services and procuring equipment; understanding how errors occur; and the workarounds that staff will inevitably take are vital considerations in improving patient safety.nnnIMPLICATIONS FOR NURSING MANAGEMENTnOpportunities for the application of human factors to healthcare and improved patient safety are discussed. Some existing tools and techniques for applying human factors in nursing management are also presented.

Fundamental examination of mental workload in the rail industry

In recent years there has been a resurgence of interest in rail human factors. The sometimes conflicting requirements of safety, reliable performance, quality of operations and effective use of limited capacity have meant that managers and engineers across all companies in the rail network have realized the importance of understanding and designing for human factors in train driving, signalling and control, maintenance, planning, etc. One key concern has been with workload, particularly mental workload, and especially in signalling and driving. This paper is concerned with a fundamental examination of what workload means in relation to the railways and especially signalling work and with a need to develop an appropriate suite of tools for the practical assessment of workload. In order to do this, the basic literature has been revisited in order to propose a conceptual framework of mental workload in the rail industry. Subsequently, a suite of workload tools has been proposed and is being used in practice; this is also described in this paper.

Changes in the body size of UK and US children over the past three decades

The major sources of published anthropometric data on children are now over two decades old. Due to concern being expressed regarding the continued validity of such data, changes in the body sizes of the UK child population over the past three decades have been considered. Comparisons were also made between the size of the current UK child population to the current US child population, and to the most comprehensive source of measured data on US children (but which are now over 20 years old). The growth of children in the UK and US over the past three decades was assessed for an indication of secular growth trends. Stature increases were found to have generally been less than body weight increases (as a percentage) at 5th percentile, mean and 95th percentile levels for UK children, and UK children were found to be closer in size to US children now than they were 30 years ago.

Reducing the risk of choking hazards: Mouthing behaviour of children aged 1 month to 5 years

Young children have a natural tendency to mouth items to explore their environment. Mouthing carries mechanical and chemical hazard potential for injury to the child, for example if they swallow an item they may choke, they may cut themselves on sharp items, and certain chemicals are present in plastic items which may pose a risk to children. Few data are available on the time that young children mouth items, how they mouth, and what they mouth. This study gathered data on 236 children aged between 1 month and 5 years to supplement and extend existing data. Findings are presented of estimated average and maximum daily mouthing times for children, how they mouth, what they mouth, and whether the items mouthed were intended to be. A validation study was carried out to determine the accuracy of the parental observation method used to gather the data. The implications of the findings of this study are discussed with respect to reducing the potential for mechanical accidents in the home.

The Design of Child Restraint System (CRS) Labels and Warnings Affects Overall CRS Usability

A study was conducted that assessed the effectiveness of different child restraint system (CRS) label/warning designs on users installation performance. Forty-eight paid participants installed a convertible CRS in a vehicle, and two child test dummies in a CRS, using one of four label conditions. The label conditions were: (1) no labels, (2) the manufacturers labels that were already affixed to the CRS (“Current”), (3) labels that were designed according to a combination of the current U.S. regulations concerning CRS labels and recently proposed changes to these regulations (“Proposed”), and (4) labels that were designed according to human factors principles and guidelines, and that were based on a hierarchical behavioral task analysis (“Optimal”). Results demonstrated that, overall, the Optimal labels resulted in higher usability ratings and better task performance. This indicates that labels designed using human factors and task analyses that identify critical task information requirements for label features will result in increased user compliance with instructions, higher usability, and improved task performance. Surprisingly, having no labels on the CRS resulted in better installation performance than when either the Current or the Proposed label conditions were used. This indicates that label design can decrease task performance; the actual physical design of a CRS may be just as critical as label content in the installation choices provided to the user. Collectively, results suggest that implementation of the proposed changes to the U.S. regulations concerning CRS labeling would likely not result in increased performance or usability compared to existing manufacturer labels that follow the current guidelines. In order to achieve significantly better ease-of-use and task performance, it would be necessary to implement features of the Optimal label condition.