Decision support system in prehospital care: a randomized controlled simulation study
Artikel i vetenskaplig tidskrift, 2013

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.

myocardial-infarction

aid

recommendations

adherence

controlled-trial

patient safety

management

guidelines

Författare

M. A. Hagiwara

Högskolan i Borås

School of Health Sciences Jonkoping

Bengt-Arne Sjöqvist

Chalmers, Signaler och system, Signalbehandling och medicinsk teknik, Medicinska signaler och system

L. Lundberg

Forsvarsmakten i Halmstad

Högskolan i Borås

B. O. Suserud

Högskolan i Borås

M. Henricson

School of Health Sciences Jonkoping

A. Jonsson

Forsvarsmakten i Halmstad

Högskolan i Borås

American Journal of Emergency Medicine

0735-6757 (ISSN) 1532-8171 (eISSN)

Vol. 31 1 145-

DOI

10.1016/j.ajem.2012.06.030