Implementation and assessment of a new integrated drug administration system (IDAS) as an example of a safety intervention in a complex socio-technological workplace

Show simple item record

dc.contributor.author Webster, Craig Stephen en
dc.date.accessioned 2006-11-30T01:20:22Z en
dc.date.available 2006-11-30T01:20:22Z en
dc.date.issued 2005 en
dc.identifier.citation Thesis (PhD--Pharmacology)--University of Auckland, 2004. en
dc.identifier.uri http://hdl.handle.net/2292/104 en
dc.description Subscription resource available via Digital Dissertations only. en
dc.description.abstract The rate of injury and death inadvertently caused by medical treatment is too high and exacts enormous human and financial costs. Each year in Britain and the United States alone, hundreds of thousands of patients are injured, ten of thousands are killed and billions of dollars are spent on additional health care due to iatrogenic harm. Health care organisations remain predominately human-centred in their approach to safety-that is, methods of avoiding error rely primarily on the resolve and vigilance of individual clinicians to avoid bad outcomes. However, this approach is becoming increasingly inadequate in the face of the steadily rising complexity of modern health care and the increasing number of procedures carried out each year. In other high-reliability organisations such as aviation and nuclear power generation, safety results not from the sheer effort of “operators”, but from in-depth analysis of problems and the removal and redesign of dangerous aspects of systems-the so-called systems approach. Here I present an evaluation of the integrated drug administration system (IDAS) as an example of the systems approach, intended to reorganise the way in which anaesthetists give drugs to improve performance and facilitate safe practice. The problem of drug error in anaesthesia is an important subset of iatrogenic harm in medicine. From the prospective study of 10806 conventional anaesthetics I define the rate of drug error in anaesthesia as one error in every 133 anaesthetics conducted-a rate five times higher than anything previously reported. In addition, anaesthetists rated the risk of harming a patient through drug error in the course of their career as high. I discuss the principles of safe system design, the psychology of error, and advanced systems safety concepts with respect to the design of the IDAS and the future of safety in medicine. In clinical use, the IDAS saved time before and during anaesthesia, and was rated by anaesthetists as significantly safer and more useable than conventional methods of drug administration. This work supports the hypothesis that error in anaesthesia can be reduced through the systematic analysis of its causes and the implementation of appropriate countermeasure strategies. en
dc.language.iso en en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof PhD Thesis - University of Auckland en
dc.relation.isreferencedby UoA1489187 en
dc.rights Subscription resource available via Digital Dissertations only. Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.source.uri http://wwwlib.umi.com/dissertations/fullcit/3170202 en
dc.subject.other HEALTH SCIENCES, PHARMACOLOGY (0419) en
dc.subject.other HEALTH SCIENCES, OCCUPATIONAL HEALTH AND SAFETY (0354) en
dc.title Implementation and assessment of a new integrated drug administration system (IDAS) as an example of a safety intervention in a complex socio-technological workplace en
dc.type Thesis en
thesis.degree.discipline Pharmacology en
thesis.degree.grantor The University of Auckland en
thesis.degree.level Doctoral en
thesis.degree.name PhD en
dc.rights.holder Copyright: The author en
pubs.local.anzsrc 11 - Medical and Health Sciences en
pubs.org-id Faculty of Medical & Hlth Sci en


Files in this item

There are no files associated with this item.

Find Full text

This item appears in the following Collection(s)

Show simple item record

Share

Search ResearchSpace


Browse

Statistics