Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Delmas, Philippe; Fiorentino, Assunta; Antonini, Matteo; Vuilleumier, Séverine; Stotzer, Guy; Kollbrunner, Aurélien; Jaccard, Dominique; Hulaas, Jarle; Rutschmann, Olivier Thierry; Simon, Jeremy R.; Keranflec’h, Charlotte Gilart de; Pasquier, Jérôme

doi:10.1186/s40814-020-00717-8

Cited by 9 publications

(4 citation statements)

References 71 publications

(68 reference statements)

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“…Three of the authors (DJ, ML, and AH) belong to the AlbaSim research lab (Media Engineering Institute, University of Applied Sciences of Western Switzerland), which has been developing serious games for more than a decade. This lab has conducted serious game projects from design to implementation in many different educational fields such as emergency triage at hospital, cardiac clinical evaluation, oncology care, project management, computer education, energy management, or crime scene investigation [31][32][33][34][35][36]. Another author (LS) has conducted serious game projects in fields like resuscitation and COVID-19 infection prevention and control at the Geneva University Hospitals [37,38].…”

Section: Methodsmentioning

confidence: 99%

The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study

Jaccard¹,

Suppan²,

Sanchez³

et al. 2021

JMIR Serious Games

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Background Serious games are increasingly used at all levels of education. However, research shows that serious games do not always fulfill all the targeted pedagogical objectives. Designing efficient and engaging serious games is a difficult and multidisciplinary process that requires a collaborative approach. Many design frameworks have been described, most of which are dedicated to the development of specific types of serious games and take the collaborative dimension into account only to a limited extent. Objective Our aim was to create a generic serious game design framework that could be adapted to all kinds of serious games and implemented in a collaborative web platform. Methods We combined the results of a literature review with our experience in serious game design and development to determine the basic building blocks of a collaborative design framework. We then organized these building blocks into categories and determined the features that a generic design framework should include. Finally, based on the paradigm of complex systems and systemic modelling, we created the co.LAB generic design framework and specifications to allow its implementation in a collaborative web platform. Results Based on a total of 10 existing design methodologies or frameworks, 23 building blocks were identified and represent the foundation of the co.LAB framework. These blocks were organized into 5 categories: “context and objectives,” “game design,” “mechanics,” “learning design,” and “assessment.” The arrangement by categories provides a structure that can be visualized in multiple and complementary ways. The classical view links game and learning design while other views offer project, systemic, and process visualizations. For the implementation of the co.LAB framework in a web platform, we propose to convert the building blocks into “cards.” Each card would constitute a collaborative working space for the design of the corresponding block. To make the framework adaptive, cards could be added, adapted, or removed according to the kind of serious game intended. Enhancing the visualization of relationships between cards should support a systemic implementation of the framework. Conclusions By offering a structured view of the fundamental design elements required to create serious games, the co.LAB framework can facilitate the design and development of such games by virtue of a collaborative, adaptive, and systemic approach. The different visualizations of the building blocks should allow for a shared understanding and a consistent approach throughout the design and development process. The implementation of the co.LAB framework in a collaborative web platform should now be performed and its actual usability and effectiveness tested.

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Section: Methodsmentioning

confidence: 99%

The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study

Jaccard¹,

Suppan²,

Sanchez³

et al. 2021

JMIR Serious Games

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“…• The relationship between patients' critical illness, number and type of medical devices, and healthcare staff interventions requires further research to assess the impact on noise levels and to encourage noise reduction strategies. and nurses 2,20 ; notably, to be heard, speech levels must exceed the ambient sound level by 15 decibels. 21,22 During the SARS COVID-19 pandemic, the co-presence of a noisy environment and personal protective equipment (facial masks, hoods and reusable respirators) further limited the ability to speak and hear.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…Excessive noise levels may interfere with clinicians' ability to concentrate, increasing the risk of potential errors 5,7,17 . Furthermore, a noisy environment has been identified as a potential distractor that limits interaction between healthcare providers and patients, affecting the auditory capacity of physicians and nurses 2,20 ; notably, to be heard, speech levels must exceed the ambient sound level by 15 decibels 21,22 . During the SARS COVID‐19 pandemic, the co‐presence of a noisy environment and personal protective equipment (facial masks, hoods and reusable respirators) further limited the ability to speak and hear 23,24 …”

Section: Introductionmentioning

confidence: 99%

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

Imbriaco,

Capitano,

Rocchi

et al. 2023

Nursing in Critical Care

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BackgroundNoise pollution in intensive care units is a relevant problem, associated with psychological and physiological consequences for patients and healthcare staff. Sources of noise pollution include medical equipment, alarms, communication tools, staff activities, and conversations.AimTo explore the cumulative effects of noise caused by an increasing number and type of medical devices in an intensive care setting on simulated patients with increasing clinical complexity. Secondly, to measure medical device alarms and nursing activities' sound levels, evaluating their role as potentially disruptive noises.Study DesignObservational simulation study (reported according to the STROBE checklist). Using an electronic sound meter, the sound levels of an intensive care room in seven simulated clinical scenarios were measured on a single day (09 March 2022), each featuring increasing numbers of devices, hypothetically corresponding to augmented patients' clinical complexity. Secondly, noise levels of medical device alarms and specific nursing activities performed at a distance of three meters from the sound meter were analysed.ResultsThe empty room's mean baseline noise level was 37.8 (±0.7) dBA; among the simulated scenarios, noise ranged between 45.3 (±1.0) and 53.5 (±1.5) dBA. Alarms ranged between 76.4 and 81.3 dBA, while nursing tasks (closing a drawer, opening a saline bag overwrap, or sterile packages) and speaking were all over 80 dBA. The noisiest activity was opening a sterile package (98 dBA).ConclusionAn increased number of medical devices, an expression of patients' higher clinical complexity, is not a significant cause of increased noise. Some specific nursing activities and conversations produce higher noise levels than medical devices and alarms. This study's findings suggest further research to assess the relationships between these factors and to encourage adequate noise reduction strategies.Relevance to Clinical PracticeExcessive noise level in the intensive care unit is a clinical issue that negatively affects patients' and healthcare providers' well‐being. The increase in baseline room noise from medical devices is generally limited. Typical nursing tasks and conversations produce higher noise levels than medical devices and alarms. These findings could be helpful to raise awareness among healthcare professionals to recognize noise sources. The noisiest components of the environment can be modified by staff behaviour, promoting noise reduction strategies and improving the critical care environment.

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“…This being a web-based game, technological constraints exist. An extended description of the SG, along with a few images, can be found in Delmas et al [57] and Hulaas et al [58] Pre-tests to identify possible technical shortcomings were conducted on-site in all the hospitals that participated in our study.…”

Section: Serious Game Triage (Sgtri)mentioning

confidence: 99%

Feasibility and acceptability of a serious game to study the effects of environmental distractors on emergency room nurse triage accuracy: a pilot randomized controlled trial

Fiorentino

Antonini

Vuilleumier

et al. 2023

Preprint

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Background: Emergency room nurse triage entails complex clinical decision making under stress and time constraints. Workplace distractors, such as noise and task interruptions, have been pointed to as possible reasons for triage inaccuracy, though studies have not borne this out. To train nurses to perform the task, a serious game was developed to simulate the triage process and environment. A pilot study was undertaken to evaluate the acceptability and feasibility of the serious game and to collect preliminary data on the effects of two distractors—noise and task interruptions—on emergency room nurse triage accuracy. Methods: A 2 × 2 factorial randomized controlled trial was designed for the study. A sample of 70 emergency room nurses was randomly assigned to four groups: three experimental groups exposed to different distractors (noise, task interruptions, and both) and one control group exposed to none. The nurses in each group had two hours to complete a series of 20 clinical vignettes where they had to establish a chief complaint and assign an emergency level. Their responses were then compared against a gold standard predetermined by experts. Results: Among 70, 55 nurses completed about 15 vignettes each in the allotted time. No inter-group differences emerged in terms of triage performance. Only a few minor technical issues arose during the sessions. Nurses had a very favorable appreciation of the serious game on triage as measured through a semantic differential scale. Conclusions: Results show that both the structure of our study and the serious game on triage can be used to carry out a future RCT on a larger scale. Two minor technical bugs were identified and corrected, the series of vignettes to complete in two hours must be shortened to 15, and the test should be held during work hours to support recruitment and reduce the possible impact of nurse fatigue on triage performance. The absence of a distractor effect raises questions about whether distractors have an effect and at what frequency and intensity of noise and task interruptions might have an impact on triage performance and whether this dose is realistic.

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Effects of environmental distractors on nurse emergency triage accuracy: a pilot study protocol

Cited by 9 publications

References 71 publications

The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study

The co.LAB Generic Framework for Collaborative Design of Serious Games: Development Study

Relationship between noise levels and intensive care patients' clinical complexity: An observational simulation study

Feasibility and acceptability of a serious game to study the effects of environmental distractors on emergency room nurse triage accuracy: a pilot randomized controlled trial

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