Does an electronic cognitive aid have an effect on the management of severe gynaecological TURP syndrome? A prospective, randomised simulation study
| Autor: | St.Pierre, Michael, Breuer, Georg, Strembski, Dieter, Schmitt, Christopher, Luetcke, Bjoern |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Cesarean Section
Guidelines Decision Support Systems Clinical Anesthesia Spinal Checklist Decision Support Techniques lcsh:RD78.3-87.3 lcsh:Anesthesiology Medizinische Fakultät TURP syndrome Practice Guidelines as Topic Humans Single-Blind Method ddc:610 Prospective Studies Emergencies Intraoperative Complications Simulation Training Acute hyponatraemia Simulation Research Article Hyponatremia |
| Zdroj: | BMC Anesthesiology BMC Anesthesiology, Vol 17, Iss 1, Pp 1-10 (2017) |
| ISSN: | 1471-2253 |
| Popis: | Background Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians’ task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels. The primary objective of this study was to compare the management of a simulated severe gynaecological transurethral resection of the prostate (TURP) syndrome under spinal anaesthesia with either: an electronic cognitive aid, or with management from memory alone. The secondary objective was to assess the clinical relevance and participant perception of the usefulness of the cognitive aid. Methods Anaesthetic teams were allocated to control (no cognitive aid; n = 10) or intervention (cognitive aid provided; n = 10) groups. We identified eight evidence-based management tasks for severe TURP syndrome from current guidelines and subdivided them into acute heart failure (AHF)/pulmonary oedema tasks (5) and acute hyponatraemia tasks (3). Implementation of the treatment steps was measured by scoring task items in a binary fashion (yes/no). To assess whether or not the cognitive aid had prompted a treatment step, participants from the cognitive aid group were questioned during debriefing on every single treatment step. At the end of the simulation, session participants were asked to complete a survey. Results Teams in the cognitive aid group considered evidence-based treatment steps significantly more often than teams of the control group (96% vs. 50% for ‘AHF/pulmonary oedema’ p |
| Databáze: | OpenAIRE |
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