Better instructions for use to improve reusable medical equipment (RME) sterility

Hum Factors. 2013 Apr;55(2):397-410. doi: 10.1177/0018720812456393.


Objective: The objective was to evaluate human-factors-based instructional aids on endoscope reprocessing.

Background: The project stems from recent failures in reprocessing (cleaning) endoscopes, contributing to the spread of harmful bacterial and viral agents between patients. A previous study discovered three themes that represent a majority of problems: (1) lack of visibility (parts and tools were difficult to identify), (2) high memory demands, and (3) insufficient feedback.

Method: In an effort to improve completion rate and reduce error, the authors designed instructional aids utilizing human factors principles that would replace existing manufacturer-provided visual aids. Then, they conducted a usability test, which compared the endoscope reprocessing performance of novices using the standard manufacturer-provided visual aids and the new instructional aids.

Results: Participants in the experimental group successfully completed 87.1% of the reprocessing procedure with the use of the instructional aids, compared to 44.7% in the control group using only existing support materials. Of 60 subtasks, 27 showed significant improvement in completion rates.

Conclusion: When given an instructional aid designed with human factors principles, participants were able to more successfully complete the reprocessing task. This resulted in an endoscope that was more likely to be safe for use on patients.

Application: The human factors design elements utilized to create the instructional aids could be transferred to a dynamic electronic-based system to improve patient safety.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Audiovisual Aids*
  • Endoscopes*
  • Equipment Reuse / standards*
  • Ergonomics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sterilization / methods*
  • Task Performance and Analysis
  • Young Adult