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Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department : A prospective mixed-methods study protocol

Dryver, Eric LU ; Olsson De Capretz, Pontus LU ; Mohammad, Mohammed LU ; Armelin, Malin ; Dupont, William D. ; Bergenfelz, Anders LU and Ekelund, Ulf LU orcid (2023) In BMJ Open 13(10).
Abstract

Introduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM) - a collection of crisis checklists - improves management of clinical perioperative crises. There is a need for in-depth prospective studies of EM use during clinical practice, evaluating when and how EMs are used and impact on patient management. Methods and analysis This 6-month long study prospectively evaluates a digital EM during management of priority 1 patients in the Skåne University Hospital at Lund's ED. Resuscitation teams are encouraged to use the EM after a management plan has been derived ( €... (More)

Introduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM) - a collection of crisis checklists - improves management of clinical perioperative crises. There is a need for in-depth prospective studies of EM use during clinical practice, evaluating when and how EMs are used and impact on patient management. Methods and analysis This 6-month long study prospectively evaluates a digital EM during management of priority 1 patients in the Skåne University Hospital at Lund's ED. Resuscitation teams are encouraged to use the EM after a management plan has been derived ( € Do-Confirm'). The documenting nurse activates and reads from the EM, and checklists are displayed on a large screen visible to all team members. Whether the EM is activated, and which sections are displayed, are automatically recorded. Interventions performed thanks to Do-Confirm EM use are registered by the nurse. Fifty cases featuring such interventions are reviewed by specialists in emergency medicine blinded to whether the interventions were performed prior to or after EM use. All interventions are graded as indicated, of neutral relevance or not indicated. The primary outcome measures are the proportions of interventions performed thanks to Do-Confirm EM use graded as indicated, of neutral relevance, and not indicated. A secondary outcome measure is the team's subjective evaluation of the EM's value on a Likert scale of 1-6. Team members can report events related to EM use, and information from these events is extracted through structured interviews. Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Dnr 2022-01896-01). Results will be published in a peer-reviewed journal and abstracts submitted to national and international conferences to disseminate our findings. Trial registration number NCT05649891.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
accident & emergency medicine, intensive & critical care, protocols & guidelines
in
BMJ Open
volume
13
issue
10
publisher
BMJ Publishing Group
external identifiers
  • pmid:37848292
  • scopus:85174641919
ISSN
2044-6055
DOI
10.1136/bmjopen-2022-071545
language
English
LU publication?
yes
id
48ba5c9a-1a42-46d4-81cb-129654a6554c
date added to LUP
2023-12-12 14:52:04
date last changed
2024-04-25 08:29:46
@article{48ba5c9a-1a42-46d4-81cb-129654a6554c,
  abstract     = {{<p>Introduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM) - a collection of crisis checklists - improves management of clinical perioperative crises. There is a need for in-depth prospective studies of EM use during clinical practice, evaluating when and how EMs are used and impact on patient management. Methods and analysis This 6-month long study prospectively evaluates a digital EM during management of priority 1 patients in the Skåne University Hospital at Lund's ED. Resuscitation teams are encouraged to use the EM after a management plan has been derived ( € Do-Confirm'). The documenting nurse activates and reads from the EM, and checklists are displayed on a large screen visible to all team members. Whether the EM is activated, and which sections are displayed, are automatically recorded. Interventions performed thanks to Do-Confirm EM use are registered by the nurse. Fifty cases featuring such interventions are reviewed by specialists in emergency medicine blinded to whether the interventions were performed prior to or after EM use. All interventions are graded as indicated, of neutral relevance or not indicated. The primary outcome measures are the proportions of interventions performed thanks to Do-Confirm EM use graded as indicated, of neutral relevance, and not indicated. A secondary outcome measure is the team's subjective evaluation of the EM's value on a Likert scale of 1-6. Team members can report events related to EM use, and information from these events is extracted through structured interviews. Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Dnr 2022-01896-01). Results will be published in a peer-reviewed journal and abstracts submitted to national and international conferences to disseminate our findings. Trial registration number NCT05649891.</p>}},
  author       = {{Dryver, Eric and Olsson De Capretz, Pontus and Mohammad, Mohammed and Armelin, Malin and Dupont, William D. and Bergenfelz, Anders and Ekelund, Ulf}},
  issn         = {{2044-6055}},
  keywords     = {{accident & emergency medicine; intensive & critical care; protocols & guidelines}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department : A prospective mixed-methods study protocol}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2022-071545}},
  doi          = {{10.1136/bmjopen-2022-071545}},
  volume       = {{13}},
  year         = {{2023}},
}