Grace Tran - Academia.edu (original) (raw)

Papers by Grace Tran

Numerous occupations require routine exposures to extreme heat conditions posing significant risk... more Numerous occupations require routine exposures to extreme heat conditions posing significant risks to workers. Cooling vests are one intervention to prevent heat injuries and illnesses in these environments. A three phase project was performed in a thermally controlled environment to evaluate cooling effectiveness of three commercially available cooling vests, HeatShield, AirVest and IsoTherm. Phase I utilized thermal manikins to quantify cooling time using established protocols. Phase II quantified the 2 time required for heart rate and core body temperature to return to normal (both with and without a cooling vest during recovery) following heat exposure. Phase III evaluated core body temperature and heart rate of participants during exercise protocols while wearing a fire fighter's ensemble. Major findings of this study revealed 1) the HeatShield and IsoTherm vests provided cooling for approximately 21 minutes, 2) although recovery times were significantly shorter when both cooling vests were used, the AirVest resulted in the shortest recovery times, and 3) core body temperatures were kept lowest for the AirVest and HeatShield while other physiological measures did not differ. The overall findings of this project support the use of micro-climate cooling products for persons working in extreme thermal conditions.

Proceedings of the International Symposium of Human Factors and Ergonomics in Healthcare, Jun 1, 2018

Wrong site surgeries (WSS) are classified as "never events" and signify adverse events that are p... more Wrong site surgeries (WSS) are classified as "never events" and signify adverse events that are preventable. The prevalence of procedures in the wrong location is up to 50 WSS per week in the United States. Informed consent (IC) related contributing factors include communication breakdowns between staff and across units, lack of cross-checking documents, equipment-related issues, and lack of automation in document coordination. As part of a patient safety initiative, a qualitative review of IC and WSS-related factors was conducted using patient safety event (PSE) data within a large healthcare system in the mid-Atlantic region. A word search query of the PSE database containing 132,683 PSEs from 2009 to 2017 was performed using a comprehensive codebook, and inter-rater reliability was established. Qualitative analysis of the PSE data indicated highest frequencies of the following codes: mAbsence of consent for treatment (25.7%), Incorrect or missing information recorded in the IC form (15.5%), and Ambiguity in laterality of the procedure on IC form/other medical documentation (12.5%). These contributing factors often lead to Late procedure start times (6.6%) and New consent document procurement (6.42%). These findings inform the need for system-based interventions to reduce risk. A targeted intervention focused on improving the design of IC forms and other medical documents could address some of these vulnerabilities. Developing a system-based approach to cross check procedure information could increase the reliability of system safeguards to reduce the risk of potential patient harm.

Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting, Sep 1, 2017

The pediatric healthcare environment is arguably more complex than the general, adult, healthcare... more The pediatric healthcare environment is arguably more complex than the general, adult, healthcare settings (e.g., weight based dosing, caring for patients who cannot advocate for themselves, etc.). These complexities and the ever-changing dynamics of the pediatric patient population and their families increase risk of healthcare professionals committing errors that may result in patient harm. Moreover, due to their physiologic state, when pediatric patients incur such errors their impact is exacerbated due to the fact that children are often less capable of recovering from such events. Human Factors Engineering can help promote a culture of safety and high reliability by using proven techniques to understand human fallibility and help prevent or mitigate human error in healthcare. This panel invites six diverse healthcare HF practitioners from different organizations to share their experiences, contributions, and the impacts they have made to improve pediatric patient safety. Our panel will provide a unique lens on the application of HF approaches, and what sensitive factors toned to be considered to successfully enhance pediatric patient safety.

Biomedical Instrumentation & Technology, 2016

Proceedings of the Human Factors and Ergonomics Society Annual Meeting

Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2005

Assistive equipment has helped lower task demands and back stress for patient-handlers; however, ... more Assistive equipment has helped lower task demands and back stress for patient-handlers; however, limited research exists on the psychological benefits (i.e., safety and comfort) of self-transfer devices for patients in postoperative care. A study was conducted to determine the efficacy of a bed assistive device in a patient population; the objectives were to compare self-perceived recovery measures and usage of pain medication between patients in the Control ( n = 8; age, 34 ± 6.3years) and Device ( n = 7; 41 ± 12) groups. Fifteen female participants undergoing either abdominal hysterectomy ( n = 6) or Cesareansection ( n = 9) procedures were recruited for the study. Both groups completed a total of twelve questionnaires over a five-week recovery period. The Device Group reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the Control Group.

Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2004

Limited research is available in understanding or evaluating the physical benefits of self-transf... more Limited research is available in understanding or evaluating the physical benefits of self-transfer devices for patients following major surgery. The objective of this study was to quantify muscle activity while using an assistive device during bed-rise exercises. Twenty participants (9 males, 11 females) participated. A laboratory study using a repeated measures design was used to test the effects of bed rise condition (manual, assisted), device (ABNOSTRAIN™, Bed Pull-Up), device anchor height (7“, 13” above bed surface), and head elevation angle (0°, 30°) on mean and peak muscle activity of the upper and lower rectus abdominus and external oblique. Results indicated that the use of a device significantly reduced muscle activity at all three muscle sites evaluated compared to unassisted bed rising. Also, having a higher anchor height or bed elevation angle further significantly reduced muscle activity.

Health Informatics, 2016

Healthcare information technology has improved the business of healthcare with mixed results for ... more Healthcare information technology has improved the business of healthcare with mixed results for its impact on the delivery of care itself. As industry and regulatory pressures to improve the quality and safety of care through the reduction of preventable harms, it becomes imperative to align information systems to (a) collect real-time clinical data with patient care workflows and (b) provide quality and patient safety teams (and other stakeholders) easy access to meaningful process and outcomes data. To accomplish this, hospitals and other healthcare organizations must adopt emerging practices from the science of high reliability organizations (HROs). In addition, they must employ and adapt clinical IT systems to facilitate real-time collection, analysis and feedback of performance (on multiple levels) with data directly from care. An example, Project Emerge, from the Johns Hopkins Hospital, is presented.

Disability and Rehabilitation: Assistive Technology, 2006

The objective of this study was to assess efficacy of a bed-assistive device during at-home recov... more The objective of this study was to assess efficacy of a bed-assistive device during at-home recovery through self-reports of self-perceived recovery status and oral pain medication usage. A case-control design was used to determine differences in self-perceived recovery measures and pain medication according to surgical procedure, device/no device, and age strata. Fifteen female patients undergoing abdominal hysterectomy (n = 6) or Cesarean-section (n = 9) procedures were recruited. Stratified sampling techniques were used to assign patients to the control (n = 8; age, 34.0 [6.3] years) and devices groups (n = 7; 40.7 [12.4] years). Both groups completed 12 questionnaires on perceived recovery status, activities of daily living, and pain medication usage over a five-week recovery period. Device group patients received training on device usage prior to surgery. Repeated measures ANOVA were used to analyse data and compare data across experimental groups. In general, device users reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the control group. Self-assistive device usage provides significant subjective and objective improvements during at-home recovery and promotes patient independence.

Previous literature has indicated that nursing personnel face the second highest rate of occupati... more Previous literature has indicated that nursing personnel face the second highest rate of occupational injury and illness. Assistive equipment, such as lift and transfer aids, has helped lower work task demands and reduce back stress on patient handlers. However, limited attention has been paid to the safety, comfort and dignity of the patient in postoperative care. Research on the efficacy of self-transfer aids for patients who require limited or no assistance by nursing personnel is insufficient. Ratings of comfort and security have only been evaluated for nursing home residents in a pilot field study, in which residents rated assistive devices as generally equal to or more secure and comfortable than manual transfer methods. The first study reports the laboratory evaluation of bed rising with the use of two self-transfer aids and bed rising unassisted. The objective was to determine muscle activity during bed rising tasks with and without the use of a bed assistive device using su...

Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care

Wrong site surgeries (WSS) are classified as “never events” and signify adverse events that are p... more Wrong site surgeries (WSS) are classified as “never events” and signify adverse events that are preventable. The prevalence of procedures in the wrong location is up to 50 WSS per week in the United States. Informed consent (IC) related contributing factors include communication breakdowns between staff and across units, lack of cross-checking documents, equipment-related issues, and lack of automation in document coordination. As part of a patient safety initiative, a qualitative review of IC and WSS-related factors was conducted using patient safety event (PSE) data within a large healthcare system in the mid-Atlantic region. A word search query of the PSE database containing 132,683 PSEs from 2009 to 2017 was performed using a comprehensive codebook, and inter-rater reliability was established. Qualitative analysis of the PSE data indicated highest frequencies of the following codes: mAbsence of consent for treatment (25.7%), Incorrect or missing information recorded in the IC fo...