The design and evaluation of a syringe hub for organizing syringes in anesthesia medication delivery

Abstract

One of the most common errors in intraoperative medication delivery is the result of “syringe swap,” when syringes that have been mixed up lead to the incorrect administration of a drug. An improvement of syringe organization could reduce medication administration errors. Recently, there have been many efforts to improve medication organization; however, these interventions struggle to achieve widespread use, even though they typically report substantial improvements in error rates and medication awareness in home institutions.A syringe organization hub was developed based on observations, interviews, and past designs. In order to assess the perceived acceptance of the hub, we used the Technology Acceptance Model (TAM) to develop a survey that was distributed to anesthesia providers at two medical institutions in the United States: one in the Mid-Atlantic and one in the southeast.The results of the four different linear regression models revealed that participants at the southeastern institution had significantly lower usefulness ratings (p<0.001), attitude ratings (p<0.001), and behavioral intent ratings (p<0.05) than participants at the Mid-Atlantic institution. The participants at the southeastern institution also reported more concerns about the implementation of the device, specifically regarding workflow deviation and cleanliness.The hub design was heavily influenced by the workflows and work practices of the Mid-Atlantic institution, and survey results found that this may have created barriers for acceptance at the southeastern institution. We found that, as barriers continue to go unaddressed at a given institution, even the simplest device can become disruptive to workflow, and there can be a struggle with integration. When interventions are developed, they are typically designed to address the barriers at the native institution. However, when seeking widespread adoption, small barriers to acceptance at non-native institutions can prevent adoption of interventions as they are not inherently factored into the design. Therefore, widespread adoption can only be accomplished by expanding the number of institutions in the design process, thereby accounting for the barriers to adoption and acceptance.