Thongprayoon Charat, Harrison Andrew M, O'Horo John C, Berrios Ronaldo A Sevilla, Pickering Brian W, Herasevich Vitaly
Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic, Rochester, MN, USA.
Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic, Rochester, MN, USA Medical Scientist Training Program, Mayo Clinic, Rochester, MN, USA.
J Intensive Care Med. 2016 Mar;31(3):205-12. doi: 10.1177/0885066614558015. Epub 2014 Nov 12.
The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist.
This was a simulation-based study conducted at an academic tertiary hospital. All participants completed checklists for 6 ICU patients: 3 using an electronic checklist and 3 using an identical paper checklist. In both scenarios, participants had full access to the existing electronic medical record system. The outcomes measured were workload (defined using the National Aeronautics and Space Association task load index [NASA-TLX]), the number of checklist errors, and time to checklist completion. Two independent clinician reviewers, blinded to participant results, served as the reference standard for checklist error calculation.
Twenty-one ICU providers participated in this study. This resulted in the generation of 63 simulated electronic checklists and 63 simulated paper checklists. The median NASA-TLX score was 39 for the electronic checklist and 50 for the paper checklist (P = .005). The median number of checklist errors for the electronic checklist was 5, while the median number of checklist errors for the paper checklist was 8 (P = .003). The time to checklist completion was not significantly different between the 2 checklist formats (P = .76).
The electronic checklist significantly reduced provider workload and errors without any measurable difference in the amount of time required for checklist completion. This demonstrates that electronic checklists are feasible and desirable in the ICU setting.
在重症监护病房（ICU）环境中，用于提高有效使用检查表的策略对检查表的成功使用至关重要。本研究旨在检验这一假设：与纸质检查表相比，电子检查表可减少ICU医护人员的工作量、差错及完成检查表的时间。
这是一项在一所学术型三级医院进行的基于模拟的研究。所有参与者为6例ICU患者完成检查表：3例使用电子检查表，3例使用相同的纸质检查表。在两种情况下，参与者均可充分使用现有的电子病历系统。所测量的结果包括工作量（使用美国国家航空航天局任务负荷指数 [NASA-TLX] 定义）、检查表差错数量及完成检查表的时间。两名对参与者结果不知情的独立临床评审员作为检查表差错计算的参考标准。
21名ICU医护人员参与了本研究。由此生成了63份模拟电子检查表和63份模拟纸质检查表。电子检查表的NASA-TLX评分中位数为39，纸质检查表为50（P = .005）。电子检查表的检查表差错中位数为5，而纸质检查表的检查表差错中位数为8（P = .003）。两种检查表格式在完成检查表的时间上无显著差异（P = .76）。
电子检查表显著减少了医护人员的工作量和差错，且在完成检查表所需时间上无任何可测量的差异。这表明电子检查表在ICU环境中是可行且可取的。
