CRNA performance using a handheld, computerized, decision-making aid during critical events in a simulated environment: a methodologic inquiry.

Directives to improve patient outcomes and enhance safety within the healthcare system have led to development of technologies to assist practitioners in a variety of activities. The purpose of this study was to explore and evaluate a method for examining the effect of computer-assisted decision mak...

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Publicado en:AANA Journal Vol. 76; no. 1; pp. 29 - 36
Autores principales: Coopmans VC, Biddle C
Formato: clinical trial forms research tables/charts Journal Article
Publicado: American Association of Nurse Anesthetists Feb2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2008
      vid: 76
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      pub: American Association of Nurse Anesthetists
      place: Park Ridge, Illinois
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        atl: CRNA performance using a handheld, computerized, decision-making aid during critical events in a simulated environment: a methodologic inquiry.
      aug:
        au:
          Coopmans VC
          Biddle C
        affil: Nurse Anesthesia Program, Barnes-Jewish College of Nursing, St. Louis, Missouri; vcoopmans@bjc.org
      sug:
        subj:
          Anesthesia Nursing
          Computer Simulation
          Computers, Hand-Held
          Critical Care
          Decision Making, Computer Assisted
          Intraoperative Care
          Models, Anatomic
          Certified Registered Nurse Anesthetists
          Postoperative Care
          Clinical Trials
          Convenience Sample
          Crossover Design
          Descriptive Statistics
          Evaluation Research
          Funding Source
          Interrater Reliability
          kappa Statistic
          Nurse Attitudes Evaluation
          Random Assignment
          Research Instruments
          Time Factors
          Videorecording
          Human
      ab: Directives to improve patient outcomes and enhance safety within the healthcare system have led to development of technologies to assist practitioners in a variety of activities. The purpose of this study was to explore and evaluate a method for examining the effect of computer-assisted decision making (CADM) using a handheld device on the accuracy (ie, correct diagnosis and treatment) and speed of problem solving by Certified Registered Nurse Anesthetists (CRNAs) during simulated critical patient-care events. A randomized crossover design with matched-pair sampling was used. In a high-fidelity human simulation environment, 4 CRNAs participated in 2 plausible critical anesthesia case scenarios. CRNA performance with and without CADM technology, environmental authenticity, and reliability and validity of data collection tools and simulated case scenarios were evaluated. Time to correct diagnosis and treatment varied by scenario, taking less time with CADM for one but more with CADM for the other, likely due to differences in pace, intensity, and conduct of the 2 scenarios. We believe this study supports further exploration and application of CADM in complex patient scenarios involving anesthesia practitioners. Affirmation of environmental authenticity also validates the high-fidelity human simulation environment as an appropriate setting to conduct research in this area.
      pubtype: Academic Journal
      doctype:
        clinical trial
        forms
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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