The University of Southampton
University of Southampton Institutional Repository

Neonatal nasogastric tube feeding in a low-resource African setting - using ergonomics methods to explore quality and safety issues in task sharing

Neonatal nasogastric tube feeding in a low-resource African setting - using ergonomics methods to explore quality and safety issues in task sharing
Neonatal nasogastric tube feeding in a low-resource African setting - using ergonomics methods to explore quality and safety issues in task sharing

Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constrained nursing workforce in low- and middle-income countries but the quality and safety issues associated with shifting tasks are rarely critically evaluated. This research explored this gap using a Human Factors and Ergonomics (HFE) method as a novel approach to address this gap and inform task sharing policies in neonatal care settings in Kenya. Methods: We used Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) to analyse and identify the nature and significance of potential errors of nasogastric tube (NGT) feeding in a neonatal setting and to gain a preliminary understanding of informal task sharing. Results: A total of 47 end tasks were identified from the HTA. Sharing, supervision and risk levels of these tasks reported by subject matter experts (SMEs) varied broadly. More than half of the tasks (58.3%) were shared with mothers, of these, 31.7% (13/41) and 68.3% were assigned a medium and low level of risk by the majority (≥4) of SMEs respectively. Few tasks were reported as 'often missed' by the majority of SMEs. SHERPA analysis suggested omission was the commonest type of error, however, due to the low risk nature, omission would potentially result in minor consequences. Training and provision of checklists for NGT feeding were the key approaches for remedying most errors. By extension these strategies could support safer task shifting. Conclusion: Inclusion of mothers and casual workers in care provided to sick infants is reported by SMEs in the Kenyan neonatal settings. Ergonomics methods proved useful in working with Kenyan SMEs to identify possible errors and the training and supervision needs for safer task-sharing.

Ergonomics, Nasogastric tube feeding, Quality and safety, Task analysis
1472-6955
1-10
Omondi, Gregory B.
20610cb5-87b3-4f26-8678-6c0718d24348
Serem, George
01271135-10fa-4176-8e4f-a0a341150458
Abuya, Nancy
1ad4368d-c49f-41eb-9a15-07d51d7759f9
Gathara, David
41adb0c9-49e4-4e67-8848-2de495a25bfd
Stanton, Neville A.
351a44ab-09a0-422a-a738-01df1fe0fadd
Agedo, Dorothy
decbba80-cd2e-4a7a-b00c-0edc8b6ce7d5
English, Mike
f7756ca1-8e1a-4673-b399-72ed7b41b678
Murphy, Georgina A.V.
988aa8bc-d1f8-4a9d-bfc4-3cac8fceed7b
Omondi, Gregory B.
20610cb5-87b3-4f26-8678-6c0718d24348
Serem, George
01271135-10fa-4176-8e4f-a0a341150458
Abuya, Nancy
1ad4368d-c49f-41eb-9a15-07d51d7759f9
Gathara, David
41adb0c9-49e4-4e67-8848-2de495a25bfd
Stanton, Neville A.
351a44ab-09a0-422a-a738-01df1fe0fadd
Agedo, Dorothy
decbba80-cd2e-4a7a-b00c-0edc8b6ce7d5
English, Mike
f7756ca1-8e1a-4673-b399-72ed7b41b678
Murphy, Georgina A.V.
988aa8bc-d1f8-4a9d-bfc4-3cac8fceed7b

Omondi, Gregory B., Serem, George, Abuya, Nancy, Gathara, David, Stanton, Neville A., Agedo, Dorothy, English, Mike and Murphy, Georgina A.V. (2018) Neonatal nasogastric tube feeding in a low-resource African setting - using ergonomics methods to explore quality and safety issues in task sharing. BMC Nursing, 17 (1), 1-10, [46]. (doi:10.1186/s12912-018-0314-y).

Record type: Article

Abstract

Background: Sharing tasks with lower cadre workers may help ease the burden of work on the constrained nursing workforce in low- and middle-income countries but the quality and safety issues associated with shifting tasks are rarely critically evaluated. This research explored this gap using a Human Factors and Ergonomics (HFE) method as a novel approach to address this gap and inform task sharing policies in neonatal care settings in Kenya. Methods: We used Hierarchical Task Analysis (HTA) and the Systematic Human Error Reduction and Prediction Approach (SHERPA) to analyse and identify the nature and significance of potential errors of nasogastric tube (NGT) feeding in a neonatal setting and to gain a preliminary understanding of informal task sharing. Results: A total of 47 end tasks were identified from the HTA. Sharing, supervision and risk levels of these tasks reported by subject matter experts (SMEs) varied broadly. More than half of the tasks (58.3%) were shared with mothers, of these, 31.7% (13/41) and 68.3% were assigned a medium and low level of risk by the majority (≥4) of SMEs respectively. Few tasks were reported as 'often missed' by the majority of SMEs. SHERPA analysis suggested omission was the commonest type of error, however, due to the low risk nature, omission would potentially result in minor consequences. Training and provision of checklists for NGT feeding were the key approaches for remedying most errors. By extension these strategies could support safer task shifting. Conclusion: Inclusion of mothers and casual workers in care provided to sick infants is reported by SMEs in the Kenyan neonatal settings. Ergonomics methods proved useful in working with Kenyan SMEs to identify possible errors and the training and supervision needs for safer task-sharing.

Text
document - Version of Record
Available under License Creative Commons Attribution.
Download (2MB)

More information

Accepted/In Press date: 31 October 2018
e-pub ahead of print date: 16 November 2018
Published date: 16 November 2018
Keywords: Ergonomics, Nasogastric tube feeding, Quality and safety, Task analysis

Identifiers

Local EPrints ID: 426653
URI: http://eprints.soton.ac.uk/id/eprint/426653
ISSN: 1472-6955
PURE UUID: b2c2018d-de73-4104-a869-7c9237123693
ORCID for Neville A. Stanton: ORCID iD orcid.org/0000-0002-8562-3279

Catalogue record

Date deposited: 07 Dec 2018 18:16
Last modified: 07 Oct 2020 04:39

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×