
Although infection prevention efforts in dialysis centers can help prevent patient morbidity and mortality, such measures can be difficult to implement. Therefore, Sarah Henrickson Parker, PhD, and others studied how work system design might contribute to infection prevention efforts in outpatient dialysis centers.
Their observational study included six US dialysis centers. Over 8 months, a multidisciplinary team visited each facility and made structured macroergonomic observations using the SEIPS 1.0 model. They collected ethnographic observations around staff encounters with patients, used selective and axial coding to conduct qualitative analysis, and used descriptive statistics to report quantitative data.
The researchers identified both barriers to and facilitators of infection prevention that were organizational and sociotechnical in nature. These included elements of human performance, such as interruptions, alarms, and task stacking; work system design features, such as physical space, leadership, culture, and scheduling; and extrinsic factors, such as patient-related characteristics. They found that several features were common across facilities, indicating that further research should be undertaken.