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dc.contributor.authorLucey, Á
dc.contributor.authorKennedy, S
dc.contributor.authorHussey, A
dc.contributor.authorMcInerney, N
dc.contributor.authorKelly, J L
dc.contributor.authorJoyce, K M
dc.date.accessioned2024-12-09T12:18:31Z
dc.date.available2024-12-09T12:18:31Z
dc.date.issued2023-06-29
dc.identifier.pmid37381781
dc.identifier.doi10.1308/rcsann.2023.0038
dc.identifier.urihttp://hdl.handle.net/10147/643646
dc.descriptionIntroduction: Many surgical procedures are prone to human error, particularly in the learning phase of skills acquisition. Task standardisation has been suggested as an approach to reducing errors, but it fails to account for the human factors associated with learning. Human reliability analysis (HRA) is a structured approach to assess human error during surgery. This study used HRA methodologies to examine skills acquisition associated with carpal tunnel decompression. Methods: The individual steps or subtasks required to complete a carpal tunnel decompression were identified using hierarchical task analysis (HTA). The systematic human error reduction and prediction approach (SHERPA) was carried out by consensus of subject matter experts. This identified the potential human errors at each subgoal, the level of risk associated with each task and how these potential errors could be prevented. Results: Carpal tunnel decompression was broken down into 46 subtasks, of which 21 (45%) were medium risk and 25 (55%) were low risk. Of the 46 subtasks, 4 (9%) were assigned high probability and 18 (39%) were assigned medium probability. High probability errors (>1/50 cases) included selecting incorrect tourniquet size, failure to infiltrate local anaesthetic in a proximal-to-distal direction and completion of the World Health Organization (WHO) surgical sign-out. Three (6%) of the subtasks were assigned high criticality, which included failure to aspirate before anaesthetic injection, whereas 21 (45%) were assigned medium criticality. Remedial strategies for each potential error were devised. Conclusions: The use of HRA techniques provides surgeons with a platform to identify critical steps that are prone to error. This approach may improve surgical training and enhance patient safety.en_US
dc.language.isoenen_US
dc.rightsAttribution 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectCarpal tunnel decompressionen_US
dc.subjectHierarchal task analysisen_US
dc.subjectHuman error identificationen_US
dc.subjectHuman reliability analysisen_US
dc.titleThe application of human reliability analysis to carpal tunnel decompression.en_US
dc.typeArticleen_US
dc.identifier.eissn1478-7083
dc.identifier.journalAnnals of the Royal College of Surgeons of Englanden_US
dc.source.journaltitleAnnals of the Royal College of Surgeons of England
dc.source.volume106
dc.source.issue5
dc.source.beginpage432
dc.source.endpage438
refterms.dateFOA2024-12-09T12:18:32Z
dc.source.countryEngland


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Attribution 4.0 International
Except where otherwise noted, this item's license is described as Attribution 4.0 International