SummaryThe objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (v 2 (2, N = 110) = 7.136, p < 0.028) and interruptions (v 2 (2, N = 427) = 29.743, p = 0.001) than anaesthetists and perfusionists, whereas anaesthetists and perfusionists experienced more layout issues than circulating nurses (v 2 (2, N = 153) = 48.558, p = 0.001). Time to resolve disruptions also varied among disciplines (k (12, 878) = 5.186, p = 0.000). Although most investigations take a one-size fits all approach in addressing disruptions to flow, this study demonstrates that targeted interventions must focus on differences with respect to individual role.
Seventy-three young normotensive male subjects were tested with an experimental protocol that included a reaction time, a mental arithmetic, and a cold pressor task. Physiological variables that were recorded included heart rate, stroke volume, pre-ejection period, blood pressure, total peripheral resistance, and respiratory sinus arrhythmia. In order to identify subgroups of subjects who differed in their pattern of autonomic responses to the tasks, the physiological change scores from baseline to the tasks for each subject were entered into a cluster analysis for each task. Ward's method was used as the clustering algorithm. The cluster analyses identified four clusters for the reaction time and mental arithmetic tasks, and five clusters for the cold pressor task. Although there was a wide range of patterns exhibited by cluster subgroups, most subjects who were reactive to the tasks showed response patterns that were qualitatively similar to the pattern of overall mean response by all subjects, albeit varying considerably in terms of quantitative response. Little evidence was generated for the consistency of extreme beta-adrenergic response from one task to another, although significant consistency was noted when milder beta-responders were included in the comparisons. Some consistency of alpha-adrenergic response noted across tasks, as well as significant consistency of being relatively nonreactive to the tasks.
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