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Decision support system in prehospital care: a randomized controlled simulation study

M. A. Hagiwara ; Bengt Arne Sjöqvist (Institutionen för signaler och system, Medicinska signaler och system) ; L. Lundberg ; B. O. Suserud ; M. Henricson ; A. Jonsson
American Journal of Emergency Medicine (0735-6757). Vol. 31 (2013), 1, p. 145.
[Artikel, refereegranskad vetenskaplig]

Introduction: Prehospital emergency medicine is a challenging discipline characterized by a high level of acuity, a lack of clinical information and a wide range of clinical conditions. These factors contribute to the fact that prehospital emergency medicine is a high-risk discipline in terms of medical errors. Prehospital use of Computerized Decision Support System (CDSS) may be a way to increase patient safety but very few studies evaluate the effect in prehospital care. The aim of the present study is to evaluate a CDSS. Methods: In this non-blind block randomized, controlled trial, 60 ambulance nurses participated, randomized into 2 groups. To compensate for an expected learning effect the groups was further divided in two groups, one started with case A and the other group started with case B. The intervention group had access to and treated the two simulated patient cases with the aid of a CDSS. The control group treated the same cases with the aid of a regional guideline in paper format. The performance that was measured was compliance with regional prehospital guidelines and On Scene Time (OST). Results: There was no significant difference in the two group's characteristics. The intervention group had a higher compliance in the both cases, 80% vs. 60% (p<0.001) but the control group was complete the cases in the half of the time compare to the intervention group (p<0.001). Conclusion: The results indicate that this CDSS increases the ambulance nurses' compliance with regional prehospital guidelines but at the expense of an increase in OST.

Nyckelord: myocardial-infarction, controlled-trial, patient safety, guidelines, management, recommendations, adherence, aid



Denna post skapades 2013-02-01.
CPL Pubid: 172814

 

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Institutioner (Chalmers)

Institutionen för signaler och system, Medicinska signaler och system

Ämnesområden

Medicinsk bioteknologi

Chalmers infrastruktur