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P.U.F.
I.S.B.N.2130553869
96 pages
p. 225 à 252
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P.U.F.
I.S.B.N.2130553869
96 pages
p. 225 à 252
doi: en cours
Veille sur la revue
Veille sur l'auteur
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Volume 68 2005/3
Rôle de l’opérateur et du statut fonctionnel des informations lors de la prise d’informations en anesthésie
H. Thuilliez F. Anceaux J.-M. Hoc
The planning of the anesthetic process relies on information set relating to the patient. This information is collected and noted on the anesthetic form during the preoperative consultation carried out on average a week before the operation. In the French hospitalization centers, the consultation anesthetist and the anesthetist in charge of the anesthesia are rarely the same. So, the anesthetic form usually insures the transmission of the relevant information between the different phases of the process and between the different actors. A previous study, centered on the information gathering during preoperative consultation (Anceaux & Beuscart-Zéphir, 2002; Anceaux, Thuilliez, & Beuscart-Zéphir, 2001), has shown the different strategies used to collect information and the functional role of the information collected.
In this study, we focused on the beginning of the peroperative phase and, particularly, on the information gathering executed both by anesthetists (AN) and nurses anesthetist (nurses). Our aim is (1) to study mechanisms underlying the information selection and the planning and (2) to help the design of a specific medical software application for anesthesia. We hypothesize two types of planning according to the functional role of the subjects: a plan elaborated in a planning (abstract) space for the anesthetists and detailed in a basic (execution) plan for the nurses. Four anesthetists and four nurses, all professional experts, were confronted to eight different consultations forms. Those forms, randomly presented, were elaborated from real cases ; half was “ difficult ” cases and half was “ easy ” cases; in each part, half held “ many ” information and half only “ few ” information.
For each form, the subjects had to gather information, like in natural setting, and then were asked to recall the relevant information. We noted the number of the consulted fields, the order and duration of each field’s consultation. We also noted the number of recalled fields. In order to study the link between the functional role of the information and of the operator, we classified the different fields in two meta categories: fields for planning (three categories of planning fields: selection, modification and specification of plan) and fields for scheduling (two categories of scheduling fields: action preconditions and intervention preconditions).
The results show that the anesthetists consult and recall less information fields than nurses. They consult and recall in first the selection fields and that, more quickly than the nurses. The anesthetists seem to plan at a high level, more flexible, which allow them to adapt the plan according to the circumstances. In this first time of anesthesia, they consider only a few information to select a generic plan, to anticipate risks and to specify the components immediately useful. Then, the plan will be adjusted all along the process. Conversely, the nurses consult quite all the fields and recall more fields (55 % vs. 40 %) without time variation. They begin by the specification fields, which allow them to immediately act. Keywords : Anesthesia, Planning, Information Gathering, Dynamic Process. Cet article s’intéresse à la prise d’informations effectuée par les anesthésistes et infirmiers anesthésistes sur la fiche d’anesthésie juste avant le début de l’anesthésie. Pour mettre en évidence le rôle fonctionnel des différentes informations, les champs de la fiche ont été catégorisés en fonction de leur rôle ultérieur dans le processus d’anesthésie. Les résultats montrent que les anesthésistes consultent et rappellent moins de champs que les infirmiers, leur consultation étant plus rapide. Les anesthésistes consultent surtout les informations leur permettant de sélectionner un plan et de le spécifier (spécification des composantes immédiatement utilisables ou de celles qui permettent une bonne anticipation des risques). Les infirmiers consultent la plupart des informations et cherchent surtout les informations leur permettant d’agir (informations de particularisation et de préconditions d’action). Mots-clés : Anesthésie, Planification, Gestion de la prise d’informations, Processus Dynamique.
In this study, we focused on the beginning of the peroperative phase and, particularly, on the information gathering executed both by anesthetists (AN) and nurses anesthetist (nurses). Our aim is (1) to study mechanisms underlying the information selection and the planning and (2) to help the design of a specific medical software application for anesthesia. We hypothesize two types of planning according to the functional role of the subjects: a plan elaborated in a planning (abstract) space for the anesthetists and detailed in a basic (execution) plan for the nurses. Four anesthetists and four nurses, all professional experts, were confronted to eight different consultations forms. Those forms, randomly presented, were elaborated from real cases ; half was “ difficult ” cases and half was “ easy ” cases; in each part, half held “ many ” information and half only “ few ” information.
For each form, the subjects had to gather information, like in natural setting, and then were asked to recall the relevant information. We noted the number of the consulted fields, the order and duration of each field’s consultation. We also noted the number of recalled fields. In order to study the link between the functional role of the information and of the operator, we classified the different fields in two meta categories: fields for planning (three categories of planning fields: selection, modification and specification of plan) and fields for scheduling (two categories of scheduling fields: action preconditions and intervention preconditions).
The results show that the anesthetists consult and recall less information fields than nurses. They consult and recall in first the selection fields and that, more quickly than the nurses. The anesthetists seem to plan at a high level, more flexible, which allow them to adapt the plan according to the circumstances. In this first time of anesthesia, they consider only a few information to select a generic plan, to anticipate risks and to specify the components immediately useful. Then, the plan will be adjusted all along the process. Conversely, the nurses consult quite all the fields and recall more fields (55 % vs. 40 %) without time variation. They begin by the specification fields, which allow them to immediately act. Keywords : Anesthesia, Planning, Information Gathering, Dynamic Process. Cet article s’intéresse à la prise d’informations effectuée par les anesthésistes et infirmiers anesthésistes sur la fiche d’anesthésie juste avant le début de l’anesthésie. Pour mettre en évidence le rôle fonctionnel des différentes informations, les champs de la fiche ont été catégorisés en fonction de leur rôle ultérieur dans le processus d’anesthésie. Les résultats montrent que les anesthésistes consultent et rappellent moins de champs que les infirmiers, leur consultation étant plus rapide. Les anesthésistes consultent surtout les informations leur permettant de sélectionner un plan et de le spécifier (spécification des composantes immédiatement utilisables ou de celles qui permettent une bonne anticipation des risques). Les infirmiers consultent la plupart des informations et cherchent surtout les informations leur permettant d’agir (informations de particularisation et de préconditions d’action). Mots-clés : Anesthésie, Planification, Gestion de la prise d’informations, Processus Dynamique.
• I. INTRODUCTION
• II. CADRE THÉORIQUE
— II . 1. L’ANESTHÉSIE
— II . 2. LA PLANIFICATION DANS L’ANESTHÉSIE
— II . 3. LA PROBLÉMATIQUE
• III. MATÉRIEL ET MÉTHODE
— III . 1. LA SITUATION EXPÉRIMENTALE
— III . 2. LE PLAN D’EXPÉRIENCE
• IV. RÉSULTATS ET DISCUSSION
— IV . 1. RÉSULTATS
— IV . 2. DISCUSSION
• V. CONCLUSION
• REMERCIEMENTS
• BIBLIOGRAPHIE
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