Mills Peter D, DeRosier Joseph M, Neily Julia, McKnight Scott D, Weeks William B, Bagian James P
VA National Center for Patient Safety, White River Junction, Vermont, USA.
Jt Comm J Qual Saf. 2004 Sep;30(9):488-96. doi: 10.1016/s1549-3741(04)30057-2.
A cognitive aid developed by the Department of Veterans Affairs (VA) and distributed to all VA facilities provides caregivers with information to minimize omission of critical steps when diagnosing and treating cardiac arrest. In 2002, caregivers were surveyed about the usefulness of the cognitive aid and the success of its dissemination throughout the VA.
Fifty randomly selected VA hospitals were sent a letter to alert them of the upcoming survey. Twenty surveys were sent to each of the selected hospitals with instructions to distribute the survey to specific caregiver types.
Nine (18%) of the VA hospitals had not used the cognitive aid tool because of dissemination problems. Of the 565 caregivers responding to the survey, 59% (332) were aware of the cognitive aid. Of these 332, 96% agreed that putting the cognitive aid on code carts is a good idea. There were 234 respondents who were both aware of the cognitive aid and had been involved in at least one code within the past 30 days. Of these 234, some 29 (12%) used the aid during a code, 28 of whom agreed that the cognitive aid was helpful during the code.
Both new and experienced caregivers find the cognitive aid helpful when responding to "code" situations. However, cognitive aids cannot be helpful if theintended users are unaware of their availability. Dissemination and awareness of the aids can be problematic in large health care systems.
退伍军人事务部（VA）开发并分发给所有VA医疗机构的一种认知辅助工具，为护理人员提供信息，以尽量减少在诊断和治疗心脏骤停时关键步骤的遗漏。2002年，对护理人员就该认知辅助工具的实用性及其在VA系统内的传播成效进行了调查。
随机挑选50家VA医院，致函提醒它们即将进行调查。向每家选定的医院发送20份调查问卷，并指示将调查问卷分发给特定类型的护理人员。
9家（18%）VA医院因传播问题未使用该认知辅助工具。在回复调查的565名护理人员中，59%（332人）知晓该认知辅助工具。在这332人中，96%的人认为将认知辅助工具放在急救推车上是个好主意。有234名受访者既知晓该认知辅助工具，又在过去30天内至少参与过一次急救。在这234人中，约29人（12%）在急救期间使用了该辅助工具，其中28人认为该认知辅助工具在急救期间有帮助。
无论是新的还是经验丰富的护理人员，在应对“急救”情况时都发现该认知辅助工具很有帮助。然而，如果目标用户不知道有该辅助工具，它就无法发挥作用。在大型医疗系统中，辅助工具的传播和知晓情况可能会出现问题。
