Tablet-based cardiac arrest documentation: A pilot study

Abstract

AIM OF THE STUDY Conventional, paper-based resuscitation transcripts are notoriously inaccurate, often lacking the precision that is necessary for recording a fast-paced resuscitation. The aim of this study was to evaluate whether a tablet computer-based application could improve upon conventional practices for resuscitation documentation. METHODS Nurses used either the conventional paper code sheet or a tablet application during simulated resuscitation events. Recorded events were compared to a gold standard record generated from video recordings of the simulations and a CPR-sensing defibrillator/monitor. Events compared included defibrillations, medication deliveries, and other interventions. RESULTS During the study period, 199 unique interventions were observed in the gold standard record. Of these, 102 occurred during simulations recorded by the tablet application, 78 by the paper code sheet, and 19 during scenarios captured simultaneously by both documentation methods. These occurred over 18 simulated resuscitation scenarios, in which 9 nurses participated. The tablet application had a mean sensitivity of 88.0% for all interventions, compared to 67.9% for the paper code sheet (P = 0.001). The median time discrepancy was 3 s for the tablet, and 77 s for the paper code sheet when compared to the gold standard (P<0.001). CONCLUSIONS Similar to prior studies, we found that conventional paper-based documentation practices are inaccurate, often misreporting intervention delivery times or missing their delivery entirely. However, our study also demonstrated that a tablet-based documentation method may represent a means to substantially improve resuscitation documentation quality, which could have implications for resuscitation quality improvement and research.

Association Between Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival

“…Misclassification of variables might have occurred, especially in relation to the timing of interventions. 39 However, it is most likely that these misclassifications are unrelated to outcomes 40 and therefore would be unlikely to explain the findings. In addition, although missing data were relatively uncommon in general (median of 0 missing variables [IQR, 0-0 missing variables] of more than 40 variables included), data were missing on at least 1 variable for 25% of the patients.…”

Early administration of epinephrine (adrenaline) in patients with cardiac arrest with initial shockable rhythm in hospital: propensity score matched analysis

“…Misclassification of variables could have influenced our results, given the nature of this data registry. Misclassification related to timing of interventions would be especially concerning, 64 65 although we suspect that errors would more likely occur for absolute times rather than relative times (that is, differences between two time points), which we used for this study. Furthermore, we believe that any misclassification, including those related to timing, would be unrelated to outcomes and would therefore most likely bias the results towards the null (that is, this potential bias is unlikely to explain our current finding).…”

Advantages of a cohort study on cardiac arrest conducted by nurses

“…CA cohort studies can be useful to identify factors associated with mortality, survival and neurological status of patients over time, which can subsidize basic or advanced support services for better quality of life. Furthermore, for proper care in cases of CA, having a leader to distribute the functions and directing the team during cardiopulmonary resuscitation (CPR) is essential (14)(15) . Nurses with training in CPR techniques are one of the professionals qualified to assume a leadership role.…”