Limited research has focused on vigilance during the maintenance phase of anesthesia work. The goal of this study was to identify anesthesia maintenance tasks and to identify the transitions between these tasks within the perspective of the vigilance paradigm. In this study, three bariatric surgeries were recorded and analyzed using a task categorization structure. Across the surgeries the primary anesthesia provider spent 71% of their time doing patient or display monitoring tasks. Task frequency and transition visualizations were generated to identify trends in the task switching. Transitions between the task categories occurred approximately once every nine seconds for the primary anesthesia provider. Additionally, it appears that regardless of the task, there was a high frequency of task transitions to looking at the visual displays and then from the visual displays towards the patient. The results of this study emphasize the importance of vigilance for anesthesia display design.
Get full access to this article
View all access options for this article.
References
1.
CarayonP. (2011). Handbook of human factors and ergonomics in health care and patient safety. CRC Press.
2.
CoieraE. W.TombsV. J.Clutton-BrockT. H. (1996). Attentional overload as a fundamental cause of human error in monitoring. Hewlett Packard Laboratories Technical Report.
3.
CooperJ. B.NewbowerR. S.LongC. D.McPeekB. (1978). Preventable anesthesia mishaps: a study of human factors. Anesthesiology, 49(6), 399–406.
4.
DaviesD. R.ParasuramanR. (1982). The psychology of vigilance. Academic Pr.
5.
GrierR. A.WarmJ. S.DemberW. N.MatthewsG.GalinskyT. L.SzalmaJ. L.ParasuramanR. (2003). The vigilance decrement reflects limitations in effortful attention, not mindlessness. Human Factors, 45(3), 349–359.
6.
GunnD. V.WarmJ. S.NelsonW. T.BoliaR. S.SchumskyD. A.CorcoranK. J. (2005). Target acquisition with UAVs: Vigilance displays and advanced cuing interfaces. Human Factors, 47(3), 488–497.
7.
HancockP. A.HartS. G. (2002). What can human factors/ergonomics offer?Ergonomics in Design, 10(1), 6–16.
8.
HeltonW. S.ShawT. H.WarmJ. S.MatthewsG.DemberW. N.HancockP. A. (2004). Demand Transitions in Vigilance: Effects on Performance Efficiency and Stress. In D.A. Vincenzi, M. Human Performance, Situation Awareness, and Automation: Current Research and Trends HPSAA II, Volumes I and II, 258–262.
9.
HeltonW. S.WarmJ. S. (2008). Signal salience and the mindlessness theory of vigilance. Acta Psychologica, 129(1), 18–25.
10.
HerdmanT. H.BurgessL. P. A.EbrightP. R.PaulsonS. S.Powell-CopeG.HancockH.… CadmanE. C. (2009). Impact of continuous vigilance monitoring on nursing workflow. The Journal of Nursing Administration, 39(3), 123–129.
11.
HitchcockE. M.WarmJ. S.MatthewsG.DemberW. N.ShearP. K.TrippL. D.… ParasuramanR. (2003). Automation cueing modulates cerebral blood flow and vigilance in a simulated air traffic control task. Theoretical Issues in Ergonomics Science, 4(1-2), 89–112.
12.
HoldenR. J.CarayonP.GursesA. P.HoonakkerP.HundtA. S.OzokA. A.Rivera-RodriguezA. J. (2013). SEIPS 2.0: A human factors framework for studying and improving the work of healthcare professionals and patients. Ergonomics, 56(11), 1669–86.
13.
HurfordW. E.BailinM. T.DavisonJ. K.HaspelK. L.RosowC.VassalloS. A.AwdeN. E. (2002). Clinical Anesthesia Procedures of the Massachusetts General Hospital (6th ed.). Lippincott Williams & Wilkins.
14.
LoebR. G. (1994). Monitor surveillance and vigilance of anesthesia residents. Anesthesiology, 80(3), 527–533.
15.
MackworthN. H. (1948). The breakdown of vigilance durning prolonged visual search. Quarterly Journal of Experimental Psychology, 1(1), 6–21.
16.
MasalonisA. J.DuleyJ. A.ParasuramanR. (1999). Effect of manual and autopilot control on mental workload and vigilance during simulated general aviation flight. Transportation Human Factors, 28(2), 109–119.
17.
MillerR. D.PardoM. C.Jr. (2011). Basics of anesthesia. Elsevier Health Sciences.
18.
MonsellS. (2003). Task switching. Trends in Cognitive Sciences, 7(3), 134–140.
19.
RobertsonI. H.ManlyT.AndradeJ.BaddeleyB. T.YiendJ. (1997). “Oops!”: Performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia, 35(6), 747–58.
20.
SandersonP. (2006). The multimodal world of medical monitoring displays. Applied Ergonomics, 37(4), 501–512.
21.
SeagullF. J.SandersonP. M. (2001). Anesthesia alarms in context: An observational study. Human Factors, 43(1), 66–78.
22.
SlagleJ.WeingerM. B.DinhM.-T. T.BrumerV. V.WilliamsK. (2002). Assessment of the intrarater and interrater reliability of an established clinical task analysis methodology. Anesthesiology, 96(5), 1129–1139.
23.
VredenburghA. G.WeingerM. B.WilliamsK. J.KalsherM. J.MacarioA. (2000). Developing a technique to measure anesthesiologists’ real-time workload. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 44(26), 241–244.
24.
WeingerM. B.HerndonO. W.GabaD. M. (1997). The effect of electronic record keeping and transesophageal echocardiography on task distribution, workload, and vigilance during cardiac anesthesia. Anesthesiology, 87(1), 144–155.
