TY - JOUR
T1 - Heuristic evaluation of infusion pumps
T2 - Implications for patient safety in Intensive Care Units
AU - Graham, Mark J.
AU - Kubose, Tate K.
AU - Jordan, Desmond
AU - Zhang, Jiajie
AU - Johnson, Todd R.
AU - Patel, Vimla L.
N1 - Funding Information:
We graciously acknowledge the support of the administrators, bioengineers, nurses, and physicians who volunteered their time and provided insights. The project/effort depicted was sponsored by grant number P01 HS11544 from the Agency for Healthcare Research and Quality and the Department of Army under Cooperative Agreement #DAMD17-97-2-7016. The content of the information does not necessarily reflect the position/policy of the government or NMTB, and no official endorsement should be inferred. We thank Leslie Wright for her assistance in preparation of this manuscript.
PY - 2004/11
Y1 - 2004/11
N2 - The goal of this research was to use a heuristic evaluation methodology to uncover design and interface deficiencies of infusion pumps that are currently in use in Intensive Care Units (ICUs). Because these infusion systems cannot be readily replaced due to lease agreements and large-scale institutional purchasing procedures, we argue that it is essential to systematically identify the existing usability problems so that the possible causes of errors can be better understood, passed on to the end-users (e.g., critical care nurses), and used to make policy recommendations. Four raters conducted the heuristic evaluation of the three-channel infusion pump interface. Three raters had a cognitive science background as well as experience with the heuristic evaluation methodology. The fourth rater was a veteran critical care nurse who had extensive experience operating the pumps. The usability experts and the domain expert independently evaluated the user interface and physical design of the infusion pump and generated a list of heuristic violations based upon a set of 14 heuristics developed in previous research. The lists were compiled and then rated on the severity of the violation. From 14 usability heuristics considered in this evaluation of the Infusion Pump, there were 231 violations. Two heuristics, "Consistency" and "Language", were found to have the most violations. The one with fewest violations was "Document". While some heuristic evaluation categories had more violations than others, the most severe ones were not confined to one type. The Primary interface location (e.g., where loading the pump, changing doses, and confirming drug settings takes place) had the most occurrences of heuristic violations. We believe that the Heuristic Evaluation methodology provides a simple and cost-effective approach to discovering medical device deficiencies that affect a patient's general well being. While this methodology provides information for the infusion pump designs of the future, it also identifies important insights concerning equipment that is currently in use in critical care environments.
AB - The goal of this research was to use a heuristic evaluation methodology to uncover design and interface deficiencies of infusion pumps that are currently in use in Intensive Care Units (ICUs). Because these infusion systems cannot be readily replaced due to lease agreements and large-scale institutional purchasing procedures, we argue that it is essential to systematically identify the existing usability problems so that the possible causes of errors can be better understood, passed on to the end-users (e.g., critical care nurses), and used to make policy recommendations. Four raters conducted the heuristic evaluation of the three-channel infusion pump interface. Three raters had a cognitive science background as well as experience with the heuristic evaluation methodology. The fourth rater was a veteran critical care nurse who had extensive experience operating the pumps. The usability experts and the domain expert independently evaluated the user interface and physical design of the infusion pump and generated a list of heuristic violations based upon a set of 14 heuristics developed in previous research. The lists were compiled and then rated on the severity of the violation. From 14 usability heuristics considered in this evaluation of the Infusion Pump, there were 231 violations. Two heuristics, "Consistency" and "Language", were found to have the most violations. The one with fewest violations was "Document". While some heuristic evaluation categories had more violations than others, the most severe ones were not confined to one type. The Primary interface location (e.g., where loading the pump, changing doses, and confirming drug settings takes place) had the most occurrences of heuristic violations. We believe that the Heuristic Evaluation methodology provides a simple and cost-effective approach to discovering medical device deficiencies that affect a patient's general well being. While this methodology provides information for the infusion pump designs of the future, it also identifies important insights concerning equipment that is currently in use in critical care environments.
KW - Heuristic evaluation
KW - IV pumps
KW - Medical device errors
KW - Patient safety
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U2 - 10.1016/j.ijmedinf.2004.08.002
DO - 10.1016/j.ijmedinf.2004.08.002
M3 - Article
C2 - 15491928
AN - SCOPUS:7444255413
SN - 1386-5056
VL - 73
SP - 771
EP - 779
JO - International Journal of Medical Informatics
JF - International Journal of Medical Informatics
IS - 11-12
ER -