View
218
Download
0
Category
Preview:
DESCRIPTION
Training / simulation process disparities B Selecting drug in system Design Infusion angle limitation Design Added flow resistance Design Calibration of system Training / simulation component disparities Design LED feedback Design Extra electrical wiring Design Flow sensor Design
Citation preview
Negative Training Effect
Feedback system error
Unrealistic Simulation User Injury
Incorrect post-simulation analysis
A B C D
Fault Tree AnalysisIntravenous Infusion Simulation
Russell Bregman, Jon Grasman, Craig Lehocky, Adam Scharl
Advisor: Dr. Joe SamoskyApril 22, 2008
Revision 7
Improper flow rate measurement
A
IV tubing leak
Component error User error
Incorrectly programmed calculations
Design error
Faulty flow sensor
Component error
Incorrect visual feedback
LED error
Programming error
Design error
Component error
Power system error
Component error
Training / simulation process
disparities
B
Selecting drug in system
Design
Infusion angle limitation
Design
Added flow resistance
Design
Calibration of system
Training / simulation component disparities
Design
LED feedback
Design
Extra electrical
wiring
Design
Flow sensor
Design
C
Electric shock
Faulty wiring
Design error
Insufficient insulation
Design error
Improper electrical grounding
Design error
Slip and fall
Tangled electrical
wiringIV tubing leak
Component error
Design error
Incompatible component connections
Design error
User error Design error
Memory failure
D
Hardware malfunction
Software malfunction
Incorrect volume / concentration
calculation
Component error
Design error
Programming error
User error
Programming error
Improper interpretation of
data
Incorrect flow rate measurement
Incorrect drug selection
Component error
Design error
User error
Recommended