Safety Events in High Risk Prehospital Neonatal Calls

Duby, Rebecca; Hansen, Mitchell A.; Meckler, Garth; Skarica, Barbara; Lambert, William E.; Guíse, Jeanne Marie

doi:10.1080/10903127.2017.1347222

Cited by 8 publications

(8 citation statements)

References 35 publications

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“…The goals of case and checklist modification were to (1) align expected management (eg, medication choice) and trigger physician consultation (eg, for a second epinephrine dose during pulseless arrest) with state EMS treatment protocols 13 ; (2) target infants as a high-risk group for prehospital error 3,14 ; and (3) evaluate multidisciplinary prehospital team performance. Each case was lengthened to 15 minutes to accomplish new steps adding physician-directed asthma, seizure, and shock therapies.…”

Section: Methodsmentioning

confidence: 99%

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Adaptation of a Simulation Model and Checklist to Assess Pediatric Emergency Care Performance by Prehospital Teams

et al. 2022

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Introduction: Simulation tools to assess prehospital team performance and identify patient safety events are lacking. We adapted a simulation model and checklist tool of individual paramedic performance to assess prehospital team performance and tested interrater reliability. Methods: We used a modified Delphi process to adapt 3 simulation cases (cardiopulmonary arrest, seizure, asthma) and checklist to add remote physician direction, target infants, and evaluate teams of 2 paramedics and 1 physician. Team performance was assessed with a checklist of steps scored as complete/incomplete by raters using direct observation or video review. The composite performance score was the percentage of completed steps. Interrater percent agreement was compared with the original tool. The tool was modified, and raters trained in iterative rounds until composite performance scoring agreement was 0.80 or greater (scale <0.20 = poor; 0.21-0.39 = fair, 0.40-0.59 = moderate; 0.60-0.79 = good; 0.80-1.00 = very good). Results: We achieved very good interrater agreement for scoring composite performance in 2 rounds using 6 prehospital teams and 4 raters. The original 175 step tool was modified to 171 steps. Interrater percent agreement for the final modified tool approximated the original tool for the composite checklist (0.80 vs. 0.85), cardiopulmonary arrest (0.82 vs. 0.86), and asthma cases (0.80 vs. 0.77) but was lower for the seizure case (0.76 vs. 0.91). Most checklist items (137/171, 80%) had good-very good agreement. Among 34 items with fairmoderate agreement, 15 (44%) related to patient assessment, 9 (26%) equipment use, 6 (18%) medication delivery, and 4 (12%) cardiopulmonary resuscitation quality. Conclusions: The modified checklist has very good agreement for assessing composite prehospital team performance and can be used to test effects of patient safety interventions.

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Section: Methodsmentioning

confidence: 99%

“…(2) target infants as a high-risk group for prehospital error 3,14 ; and (3) evaluate multidisciplinary prehospital team performance. Each case was lengthened to 15 minutes to accomplish new steps adding physician-directed asthma, seizure, and shock therapies.…”

Section: Original Simulation Case and Tool Modificationmentioning

confidence: 99%

Adaptation of a Simulation Model and Checklist to Assess Pediatric Emergency Care Performance by Prehospital Teams

et al. 2022

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“…One example of this on reducing neonatal mortality is discussed in the works of Mduma, et al 14 In addition, the education of the paramedic students with simulation-based training to achieve proficiency in both technical and non-technical skills carries high importance to minimize these errors and to ensure patient safety. 2,3,[15][16][17] The main aim of this study was to evaluate the effect of blended learning on the theoretical knowledge and familiarity with psychomotor skills, adherence to the algorithm, and teamwork in SBE of N-CPR. The secondary aim was to compare the blended learning materials: the slide presentation that appeals to the visual perception and the video clip which appeals to both auditory and visual perception.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Different E-Learning Modalities in Enhancing Neonatal Cardiopulmonary Resuscitation: Principles, Knowledge, and Communication Skills of Undergraduate Paramedic Students

Yaylacı

Güven

2021

Prehosp. Disaster med.

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Introduction: Paramedic students should have the crucial cognitive and psychomotor skills related to neonatal cardiopulmonary resuscitation (N-CPR). Study Objective: The aim of this study was to evaluate the effect of blended learning on the theoretical knowledge and preliminary knowledge of the psychomotor skills, adherence to the algorithm, and teamwork in simulation-based education (SBE) of N-CPR. Methods: This randomized, prospective study was conducted on 60 fourth-semester paramedic students. The participants were separated into two groups following a classroom lecture. Each group was assigned either a slide presentation (Group 1; SP-G) or a video clip (Group 2; V-G). All the participants answered multiple-choice questions (MCQs) and each group (Group 1 and Group 2) was divided into 10 sub-groups. These sub-groups were then tested in an observational performance evaluation (OPE) consisting of a neonatal asphyxia megacode scenario, after the classroom lecture and following the blended learning process. Results: Group performance, teamwork, communication skills, and adherence to the algorithm were evaluated. There was a significant difference in the MCQ and OPE results between the after classroom lecture and after blended learning for both groups. The average score of Group 2 was higher than Group 1 in the MCQ results (Mann-Whitney U test; P <.001). The average score of Group 2 was higher than Group 1 in the OPE results (Mann-Whitney U test; P = .002). Conclusion: Blended learning, especially video clips, in adjunction with the classroom lecture were effective in acquiring and developing both technical and non-technical skills among paramedic students in SBE of N-CPR training.

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“…Despite the unique nature of the EMS environment and the distinct challenges of caring for children in the prehospital environment, there is little context‐specific research to guide the development of prehospital protocols. Recently, pediatric EMS clinical research has seen significant growth in both the number of publications and investigators; however, the majority of these studies are observational in nature . To date, to our knowledge, there have only been two randomized trials conducted specifically for children in the EMS setting, one that addressed airway management and one related to treatment for active seizures .…”

mentioning

confidence: 99%

“…To date, to our knowledge, there have only been two randomized trials conducted specifically for children in the EMS setting, one that addressed airway management and one related to treatment for active seizures . Recently, pediatric EMS clinical research has seen significant growth in both the number of publications and the number of investigators; however, the majority of these studies are observational in nature . There is also a concerted effort among national organizations and researchers to focus on defining and implementing “best practices” in pediatric EMS care derived from the currently available evidence base even though this knowledge base is generally recognized to be limited …”

mentioning

confidence: 99%

Establishing the Key Outcomes for Pediatric Emergency Medical Services Research

Adelgais

Hansen

Lerner

et al. 2018

Academic Emergency Medicine

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The evidence supporting best practices when treating children in the prehospital setting or even the effect emergency medical services (EMS) has on patient outcomes is limited. Standardizing the critical outcomes for EMS research will allow for focused and comparable effort among the small but growing group of pediatric EMS investigators on specific topics. Standardized outcomes will also provide the opportunity to collectively advance the science of EMS for children and demonstrate the effect of EMS on patient outcomes. This article describes a consensus process among stakeholders in the pediatric emergency medicine and EMS community that identified the critical outcomes for EMS care in five clinical areas (traumatic brain injury, general injury, respiratory disease/failure, sepsis, and seizures). These areas were selected based on both their known public health importance and their commonality in EMS encounters. Key research outcomes identified by participating stakeholders using a modified nominal group technique for consensus building, which included small group brainstorming and independent voting for ranking outcomes that were feasible and/or important for the field.A pproximately 1.7 million children are cared for by emergency medical services (EMS) annually in the United States. Despite the unique nature of the EMS environment and the distinct challenges of caring for children in the prehospital environment, there is little context-specific research to guide the development of prehospital protocols. Recently, pediatric EMS clinical research has seen significant growth

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Safety Events in High Risk Prehospital Neonatal Calls

Cited by 8 publications

References 35 publications

Adaptation of a Simulation Model and Checklist to Assess Pediatric Emergency Care Performance by Prehospital Teams

Adaptation of a Simulation Model and Checklist to Assess Pediatric Emergency Care Performance by Prehospital Teams

The Effectiveness of Different E-Learning Modalities in Enhancing Neonatal Cardiopulmonary Resuscitation: Principles, Knowledge, and Communication Skills of Undergraduate Paramedic Students

Establishing the Key Outcomes for Pediatric Emergency Medical Services Research

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