References of "Berastegui, Pierre"
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See detailEmergency Medical Services: When Fatigue Becomes The Norm.
Berastegui, Pierre ULiege; Jaspar, Mathieu ULiege; GHUYSEN, Alexandre ULiege

Conference (2017, June 27)

BACKROUND: Emergency Medical Services (EMS) routinely work at the very limit of their capacity due to growing emergency rooms visits and residents’ shortage. In this context, EMS workers are regularly ... [more ▼]

BACKROUND: Emergency Medical Services (EMS) routinely work at the very limit of their capacity due to growing emergency rooms visits and residents’ shortage. In this context, EMS workers are regularly asked to work more than 10 hours a day, on varying shifts and with short recuperation breaks. Two approaches can be used to reduce fatigue-related risk: reducing the likelihood a fatigued operator is working (i.e. fatigue reduction), or reducing the likelihood a fatigued operator will make an error (i.e. fatigue proofing). In Emergency Medical Services, formal risk control mainly focuses on reduction strategies such as reducing work hours while proofing strategies develops as an implicit element of the safety system. OBJECTIVE: Our purpose is to identify individual proofing and reduction strategies used by emergency residents and to investigate how they relate to fatigue, performance and patient safety indicators. METHODS: First, we conducted 4 focus-group sessions with a total of 25 EMS residents to elicit perceived consequences of fatigue and strategies used to cope with them. Focus group results were used to design a questionnaire assessing how often EMS residents personally used any of the strategies reported during sessions. Second, we administered the questionnaire to a larger sample and conducted a prospective observational study with a repeated within-subjects component. A total of 45 EMS residents participated in the study for a total of 400 shifts analyzed. We gathered sleep diaries, subjective sleepiness, reaction time, self-reported medical errors and performance ratings at different time point during both day and night shift using an android-based application. Sleep time and activity levels were confirmed using wrist actigraphy. DISCUSSION: We will discuss what can be drawn from our results in terms of individual and collective resilience processes with a focus on the potential for implementation of more formal processes at a system level.  [less ▲]

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Peer Reviewed
See detailProofing & Reduction Strategies Used by Emergency Residents to Manage Fatigue-related Risk
Berastegui, Pierre ULiege; Ghuysen, Alexandre ULiege; Nyssen, Anne-Sophie ULiege

Poster (2016, July 29)

Fatigue and sleep loss are typically associated with psychomotor and cognitive impairment resulting in poorer task performance. Most of these studies are conducted in controlled settings and involve the ... [more ▼]

Fatigue and sleep loss are typically associated with psychomotor and cognitive impairment resulting in poorer task performance. Most of these studies are conducted in controlled settings and involve the completion of experimental tasks. Only a few field studies involving exhausted residents have been conducted over the past decade, and they yielded to contradictory results (Ellman et al., 2004). One of the key factors that could be involved in the non-linear relationship between fatigue and performance in specific work context reside in the mobilization of Fatigue Proofing Strategies. FPS are adaptive and protective risk-reduction behaviors that improve the resilience of a system of work (Dawson et al., 2012). In this study, we aimed to identify and classify proofing strategies mobilized by EMS residents using an inductive content analysis approach. EMS residents reported a range of strategies for reducing subjective level of sleepiness (reduction strategies, n=15) or managing its consequences (proofing strategies, n=17). Content analysis yielded to three sub-categories of proofing strategies: Behavioral Compensation (n=8), Error’s Opportunity Reduction (n=5) and Error’s Consequences Mitigation (n=4). Our results show that EMS residents use both types of strategies although none of the proofing strategies were part of their training program. Despite the current informal use, there is significant potential for implementation of more formal processes. [less ▲]

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Peer Reviewed
See detailIs system resilience maintained at the expense of individual resilience?
Nyssen, Anne-Sophie ULiege; Berastegui, Pierre ULiege

in Braithwaite, Jeffrey; Wears, Robert; Hollnagel, Erik (Eds.) Resilient Health Care III: Reconciling Work-As-Imagined and Work-As-Done (2016)

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Peer Reviewed
See detailHow novice and expert drivers adjust their driving behavior when they feel drowsy?
Berastegui, Pierre ULiege; Piette, Christine; François, Clémentine ULiege et al

Poster (2015, July 29)

This paper aims to explore adaptive behaviors developed by drivers to prevent drowsiness. Specifically, we postulate that driving expertise is associated with better drowsiness awareness, allowing experts ... [more ▼]

This paper aims to explore adaptive behaviors developed by drivers to prevent drowsiness. Specifically, we postulate that driving expertise is associated with better drowsiness awareness, allowing experts to adequately adjust their driving behaviors when they feel drowsy. The present study was carried on a high-fidelity driving simulator coupled with an innovative system allowing objective sleepiness assessment based on EEG and Eye-tracking data. The Karolinska Sleepiness Scale was used to evaluate subjective drowsiness. The ratio between objective and subjective assessments gave an indicator of drowsiness awareness. Standard Deviation of Lateral Position (SDLP) was used as a measure of performance while driving speed and ocular fixations were recorded in order to highlight adaptive behaviors. 16 subjects were recruited from general population and categorized in two groups of expertise based on the Belgian Institute for Road Safety’s criteria. Our results show that expert drivers show better drowsiness awareness than novices and mobilize speed increasing and vigilance reallocation strategies to maintain satisfactory level of drowsiness. [less ▲]

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See detailSomnoTraq
Berastegui, Pierre ULiege; Antoine, Loïc

Software (2015)

SomnoTraq is an android-based application aiming to track fatigue-related risk over time among healthcare practitioners. This application is composed of several modules: sleep/work diary, error reporting ... [more ▼]

SomnoTraq is an android-based application aiming to track fatigue-related risk over time among healthcare practitioners. This application is composed of several modules: sleep/work diary, error reporting system, fatigue scale (e.g. Karolinska Sleepiness Scale) and vigilance test (e.g. Psychomotor Vigilance Test). SomnoTraq allows the researcher to conduct longitudinal studies involving specific modules at different times. Data are stored on the user’s phone as a CSV file that is readily importable to any device for statistical analysis. The main advantage of this application resides in its ability to collect multiple indicators of fatigue-related risk within a short period of time (i.e. approximately 6 minutes). This asset makes SomnoTraq particularly suitable for on-the-job investigations characterized by significant time pressure. [less ▲]

Detailed reference viewed: 40 (4 ULiège)