ارزیابی خطاهای انسانی در فرایند جراحی آب مروارید چشم با استفاده از تکنیک SHERPA

  Introduction: Human errors result in numerous accidents in healthcare professions every year and lead to the death of many patients. Considering the high rate of eye cataract surgeries performed in Iran and the sensitive nature of the surgery, the present study was conducted to identify and assess possible human errors in the performance of these surgeries. Materials and Methods: The present qualitative, cross-sectional study was conducted to identify and assess human errors in the process of eye cataract surgery using the SHERPA technique. At first, using the hierarchical task analysis method, the surgery process was divided into tasks and sub-tasks. In the next step, through the same technique, possible human errors were detected and risk-assessed. Appropriate prevention solutions were then proposed for reducing the risk of errors. Results: A total of 53 possible errors were detected for the 41 tasks in the surgery process. The highest error percentages pertained to performance and the lowest pertained to retrieval. Moreover, the risk of 22.64% of the errors detected was deemed unacceptable. Conclusions: Given the severity of the outcomes of human errors in cataract surgery, reducing the rate of the detected errors is crucial. According to the type and frequency of the detected errors, the findings of the present study emphasize the importance of designing and implementing behavior-based safety training programs for ophthalmologists.