Gaze entropy reflects surgical task load.

BACKGROUND: Task (over-)load imposed on surgeons is a main contributing factor to surgical errors. Recent research has shown that gaze metrics represent a valid and objective index to asses operator task load in non-surgical scenarios. Thus, gaze metrics have the potential to improve workplace safety by providing accurate measurements of task load variations. However, the direct relationship between gaze metrics and surgical task load has not been investigated yet. We studied the effects of surgical task complexity on the gaze metrics of surgical trainees. METHODS: We recorded the eye movements of 18 surgical residents, using a mobile eye tracker system, during the performance of three high-fidelity virtual simulations of laparoscopic exercises of increasing complexity level: Clip Applying exercise, Cutting Big exercise, and Translocation of Objects exercise. We also measured performance accuracy and subjective rating of complexity. RESULTS: Gaze entropy and velocity linearly increased with increased task complexity: Visual exploration pattern became less stereotyped (i.e., more random) and faster during the more complex exercises. Residents performed better the Clip Applying exercise and the Cutting Big exercise than the Translocation of Objects exercise and their perceived task complexity differed accordingly. CONCLUSIONS: Our data show that gaze metrics are a valid and reliable surgical task load index. These findings have potential impacts to improve patient safety by providing accurate measurements of surgeon task (over-)load and might provide future indices to assess residents' learning curves, independently of expensive virtual simulators or time-consuming expert evaluation.

Evaluación del plan funcional dirigido a personas cuidadoras en hospitalización / Evaluation of a functional plan for caregivers in hospital

Fundamentos: El cuidado de personas dependientes se ha incrementado, por lo que las reformas del sistema sanitario están visibilizando a las personas cuidadoras. Se desarrolló un plan funcional para personas cuidadoras en hospitalización, y esta investigación pretende indagar cómo ha sido su implementación, identificando puntos fuertes y débiles que promuevan cambios entre el sistema formal e informal. Métodos Se diseñó un estudio cualitativo, considerando como sujetos de estudio a los profesionales de enfermería y personas cuidadoras identificadas en el Hospital. Se utilizó la técnica de grupo focal seleccionando 8 personas en cada segmento. Se elaboraron 2 guiones de preguntas con los criterios de evaluación recogidos en las líneas estratégicas del plan: identificación/captación, acogida, descanso, dieta, atención sanitaria, información/educación sanitaria, gestión e implementación y otras propuestas. Los datos se recogieron durante mayo de 2011.ResultadosSe encontraron dificultades en la identificación y captación de las personas cuidadoras, por no realizar su valoración inicial. En cuanto a la acogida, en algunos casos no se entregaba folleto informativo. El descanso no es posible por la renuncia a alejarse de su familiar. La dieta es la principal causa del conflicto y destaca la falta de educación sanitaria para continuar con los cuidados domiciliarios. Se valoran positivamente los circuitos de atención preferente en urgencias. Los profesionales de enfermería consideran que el desarrollo del plan supone una sobrecarga de trabajo. Conclusiones Los puntos fuertes y débiles identificados permitirán establecer mejoras en la implementación del plan para conseguir el cambio en aspectos específicos como la información/educación, atención, descanso y dieta de la persona cuidadora. Destacamos la necesidad de potenciar el cambio de modelo (AU)

BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011.RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change (AU)

[Evaluation of a functional plan for caregivers in hospital]. / Evaluación del plan funcional dirigido a personas cuidadoras en hospitalización.

BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011. RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change.