risk of human errors in midwifery tasks in child delivery ward
Human errors (HEs) include a set of actions that breach the predefined norms, limits, and standards and have a negative effect on the system. Studies have shown that human errors are the source of 90% of incidents in industries [1]. Medical and hospital environments are among the highly complicated work systems prone to HEs due to diversity of tasks, heavy workload, fatigue, misprocessed information, and failure in decision making. Medical errors are among the most common health threatening errors that affect the care and treatment provided to the patient. Medical errors take place in different forms like errors in diagnosis, administered drugs, nursing services, surgery room, and the errors caused by lack of skills [2-4]. Medical errors are not limited to a specific country and all around the world they increase mortality rate and medical costs. As suggested by statistics, more than 98000 deaths in the USA were due to medical errors [5]. Studies have shown that reporting errors in medical care procedures brings in several advantages; however, most of the personnel fear the consequences or patients’ responses [2]. There are many techniques to assess reliability of human such as SHERPA, HEART, ATENA, and EA. Engineering approach (EA) is one of the quantitative assessment techniques to measure probability of human errors, which was first introduced by Zhigiang et al. (2009). Based on this technique, each professional task is analyzed based on three behavioral styles of skill base, rule base, and knowledge base to obtain the probability of human error for each task. By skill base behavior we refer to the behaviors in which the activities are so frequently practiced that they are done automatically with no need for extensive awareness. With regard to rule base behaviors, activities are done with a higher level of awareness and cognition. For such tasks, people follow a set of rule and regulation introduced as instructions. Knowledge base behaviors have the highest behavioral level and they are demonstrated when the individual finds themselves in a new situation where solving problems needs innovation. Another technique used in this study is predictive human error analysis (PHEA) where all HEs are identified and analyzed qualitatively. The main advantages of this technique are ease of use, systematic nature, and its reliance on hierarchical task analysis (HTA). This technique predicts human errors for each task or at any stage and prevents the predicted errors. The reason for using EA technique is that it ranks errors based on their probability in terms of education, level of experience, familiarity with situation, availability of instruction, and time pressure. Through this, tasks with the highest probability of errors are identified and the PHEA would be used to describe the error and solutions to control it. There have been several studies on HEs in medical environment such as HEs in physicians, nurses, and clinical lab experts [8, 11]. Still, there is a paucity of studies on HEs in midwifery. Such errors cause life threatening risks for mother and the infant and increase medical costs [11, 12]. Given the gap in the literature, the present study tries to evaluate error in midwifery tasks in the maternity ward of a genecology hospital using PHEA and EA techniques.
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