Abstract
Resistance to change in monitoring practices from within the anaesthesiology community is a formidable obstacle, and coercive and exhortatory solutions are likely to be unsuccessful in some situations. An analysis of publications about technology transfer and professional obsolescence, and application of this data to the practice of anaesthesia, reveals various stresses that technology transfer from research areas to the workplace may induce in vulnerable anaesthesiologists and account for their attitudes. It is suggested that the invaluable pronouncements of high profile anaesthesiologist groups must be supplemented by supportive behaviour by physicians and administrators at an institutional level. The human factors issues to be addressed include: (i) Monitored data acquisition skills. (ii) Possibility of acting on monitored data. (iii) Assistance for personal insight into attitudinal difficulties that may be encountered. (iv) Data supporting the value of the device. (v) Ergonomically effective integration of the monitor into the work station.
Alternatively the perceptions of potential users may accurately reflect changes in their status in the new work situation created by monitors, and decision making aids that may or may not be derived from them. Thus, plans to present job satisfaction in related clinical areas or to associate the proposed new system with evaluation of its effect on patient outcome will be necessary. In this way the clinician becomes involved in clinical research, a quality of personal and quality care development.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Shields HJ. The graphic method of teaching anaesthesia with particular emphasis on respiration. Anesth Analg 1934; 13: 61–5.
Guedel AE. Anesthesia: a teaching outline: stages of anesthesia. Anesth Analg 1936; 15: 1–4, 55–62.
Guedel AE. Anesthesia: a teaching outline (concluded): preparation of the patient and mechanism of varying anesthesia requirements. Anesth Analg 1936; 15: 157–62.
Dillon JB. Monitors in the operating room. Am J Surg 1964; 107: 595–7.
Pask EA. Hunt the signal. Proc Roy Soc Med 1965; 58: 66–77.
Pierce EC Jr. Does monitoring have an affect on patient safety? Monitoring instruments have significantly reduced anesthetic mishaps. J Clin Monit 1988; 4: 111–4.
Whitcher C, Ream AK, Parsons D, Rubsamen D, Scott J, Champeau M et al. Anesthetic mishaps and the cost of monitoring: a proposed standard for monitoring equipment. J Clin Monit 1988; 4: 5–15/
Eichhorn JH. Prevention of intraoperative anesthesia accidents and related severe injury through safety monitoring. Anesthesiology 1989; 70: 572–7.
Tinker JH, Dull DL, Caplan RA, Ward RJ, Cheney FW. Role of monitoring devices in prevention of anesthetic mishaps: a closed claims analysis. Anesthesiology 1989; 71: 541–6.
Severinghaus JW. Continuous monitoring of alveolar and inspiratory concentrations of anesthetic and respiratory gases is safe, simple, and cost effective. J Clin Monit 1987; 3: 123.
Sykes MK. Continuous monitoring of alveolar and inspiratory concentrations of anesthetic and respiratory gases is difficult and potentially unsafe. J Clin Monit 1987; 13: 116–22.
Grandjean E. Fatigue in industry. Br J Ind Med 1979; 36: 175–86.
Paget NS, Lambert TF, Sridpar K. Factors affecting anaesthetists work-some findings on vigilance and performance. Anaesth Intensive Care 1981; 9: 359–65.
Wiener EL. Vigilance and task load: in search of the inverted U. Hum Factors 1984; 26: 215–22.
Torsvall L, Akerstedt T. Sleepiness on the job: continuously measured EEG changes in train drivers. Electroencephalogr Clin Neurophysiol 1987; 66: 502–11.
McIvor AJ. Manual work, technology and industrial health. Med Hist 1987; 31: 160–89.
Allnutt MF. Human factors in accidents. Br J Anaesth 1987; 59: 856–64.
Adler-Karlsson G. The choice to be made. Soc Sci Med 1987; 25: 115–7.
Naatanen R. The inverted U relationship between activation and performance. A critical review. In: Kornblum S (ed.) Attention and Performance, Academic Press, New York.
Healy T. Clinical freedom and clinical behavior. Anaesthesia 1989; 44: 353–4.
Cooper JB, Gaba DM. A strategy for preventing anesthesia accidents. Int Anesthesiology Clin 1989; 27: 148–52.
Gissen D, Roaf ER. LED monitors and the color-blind. Anesthesiology 1985; 62: 840.
Schulte GT, Block FE Jr. Can people hear the pitch change on a variable pitch pulse oximeter? Anesthesiology 1989; 71: A340.
Dean M. News and comment. Lancet 1991; 337: 37–8.
Watts MS. Some side effects of science and technology on medical practice. West J Med 1985; 142: 545.
Campbell-Heider N, Knapp TR. Nurses attitudes toward conventional automated vital signs measurement methods. Med Instrum 1988; 22: 257–62.
McIntyre JWR. Ergonomics: anaesthetists’ use of auditory alarms in the operating room. Int Clin Monit Comput 1985; 2: 47–55.
Fineberg HV. Technology assessment, motivation, capability and future directions. Med Care 1985; 23: 663–71.
Huang KC, Kraman SS, Wright BD. Video stethoscope-a simple method for assuming continuous bilateral lung ventilation during anaesthesia. Anesth Analg 1983; 62: 586–9.
Douglass R, Doddapaneni B. Esophageal stethoscope amplifier. Anesth Analg 1985; 64: 377–8.
Sainsbury DA. Monitoring heart and breath sounds by telemetry. Anaesth Intensive Care 1985; 13: 415–6.
Hok B, Bythell V, Bengtsson M. Development of a wireless stethoscope for auscultatory monitoring during anaesthesia. Med Biol Eng Comput 1988; 26: 317–20.
Comroe JH, Botelho S. Unreliability of cyanosis in the recognition of arterial hypoxemia. Am J Med Sci 1947; 214: 1–6.
Guedel AE. Cyclopropane anaesthesia. Anesthesiology 1940; 1: 13–25.
Clutton-Brock J. Skin temperature as a clinical aid during anaesthesia. Anaesthesia 1947; 2: 150–2.
Allen CR, Echols RS, Hoeflich EA, O’Neal KC, Slocum HC. Variations in the signs of acute oxygen-want during anaesthesia. Anesthesiology 1947; 8: 601–14.
Murray BRP, Whitty HPB. The apparent skin colour of unconscious patients in relation to the source of illumination. Anaesthesia 1965; 20: 123–34.
Kelman GR, Nunn JF. Clinical recognition of hypoxenia under fluorescent lamps. Lancet 1966; 1: 1400–3.
Manninen P, Knill RC. Cardiovascular signs of acute hypoxemia and hypercarbia during enflurane and halothane anaesthesia in man. Can J Anaesth 1979; 26: 282–7.
Reeve PE. Personality characteristics of a sample of anaesthetists. Anaesthesia 1980; 35: 559–68.
Dill WR. Obsolescence as a problem of personal initiative. In: Dubin SS (ed.) Professional obsolescence. The English Universities Press Ltd., 1971.
Dubin SS. Motivational factors in professional pudating. In: Dubin SS (ed.) Professional Obsolescence. The English Universities Press Ltd., 1971.
Waugh D. There but for the grace... Can med Assoc J 1992; 146: 62.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
McIntyre, J.W.R. Anaesthesia monitoring: the human factors component of technology transfer. J Clin Monit Comput 10, 23–29 (1993). https://doi.org/10.1007/BF01133523
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF01133523