The effect of an electronic cognitive aid on the management of ST-elevation myocardial infarction during caesarean section: a prospective randomised simulation study
| Autor: | Michael, St Pierre, Bjoern, Luetcke, Dieter, Strembski, Christopher, Schmitt, Georg, Breuer |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Cesarean Section
Pregnancy Complications Cardiovascular Disease Management Decision Support Techniques Checklist Obstetrics Random Allocation Myocardial infarction Patient safety Pregnancy Task Performance and Analysis Humans ST Elevation Myocardial Infarction Female Single-Blind Method Prospective Studies Intraoperative Complications Simulation Training Simulation Research Article |
| Zdroj: | BMC Anesthesiology |
| ISSN: | 1471-2253 |
| Popis: | Background Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity. Intraoperative myocardial infarction may be an emergency to which these limitations apply. Methods Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. The primary aim of this study was to compare cognitive aid versus memory for intraoperative ST-elevation myocardial infarction (STEMI) management in a simulation of caesarean delivery under spinal anaesthesia. We identified nine evidence-based metrics of essential care from current guidelines and subdivided them into mandatory (high level of evidence; no interference with surgery) and optional (lower class of recommendation; possible impact on surgery) tasks. Six clinically relevant tasks were added by consensus. Implementation of these steps was measured by scoring task items in a binary fashion (yes/no). The interval between the diagnosis of STEMI and the first contact with the cardiac catheterisation lab was measured. To determine whether or not the cognitive aid had prompted an action, participants from the cognitive aid group were interviewed during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. Results The presence of the cognitive aid did not shorten the time interval until the cardiac catheterisation lab was contacted. The availability of the cognitive aid improved task performance in the tasks identified from the guidelines (93% vs. 69%; p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink