Martin-Gill Christian, Higgins J Stephen, Van Dongen Hans P A, Buysse Daniel J, Thackery Ronald W, Kupas Douglas F, Becker David S, Dean Bradley E, Lindbeck George H, Guyette Francis X, Penner Josef H, Violanti John M, Lang Eddy S, Patterson P Daniel
Prehosp Emerg Care. 2018 Feb 15;22(sup1):102-109. doi: 10.1080/10903127.2017.1381791. Epub 2018 Jan 11.
Performance measures are a key component of implementation, dissemination, and evaluation of evidence-based guidelines (EBGs). We developed performance measures for Emergency Medical Services (EMS) stakeholders to enable the implementation of guidelines for fatigue risk management in the EMS setting.
Panelists associated with the Fatigue in EMS Project, which was supported by the National Highway Traffic Safety Administration (NHTSA), used an iterative process to develop a draft set of performance measures linked to 5 recommendations for fatigue risk management in EMS. We used a cross-sectional survey design and the Content Validity Index (CVI) to quantify agreement among panelists on the wording and content of draft measures. An anonymous web-based tool was used to solicit the panelists' perceptions of clarity and relevance of draft measures. Panelists rated the clarity and relevance separately for each draft measure on a 4-point scale. CVI scores ≥0.78 for clarity and relevance were specified a priori to signify agreement and completion of measurement development.
Panelists judged 5 performance measures for fatigue risk management as clear and relevant. These measures address use of fatigue and/or sleepiness survey instruments, optimal duration of shifts, access to caffeine as a fatigue countermeasure, use of napping during shift work, and the delivery of education and training on fatigue risk management for EMS personnel. Panelists complemented performance measures with suggestions for implementation by EMS agencies.
Performance measures for fatigue risk management in the EMS setting will facilitate the implementation and evaluation of the EBG for Fatigue in EMS.
绩效指标是循证指南（EBG）实施、传播和评估的关键组成部分。我们为紧急医疗服务（EMS）利益相关者制定了绩效指标，以推动在EMS环境中实施疲劳风险管理指南。
由国家公路交通安全管理局（NHTSA）支持的EMS疲劳项目的小组成员采用迭代过程，制定了一套与EMS疲劳风险管理的5项建议相关的绩效指标草案。我们采用横断面调查设计和内容效度指数（CVI）来量化小组成员对指标草案措辞和内容的一致性。使用一个基于网络的匿名工具来征求小组成员对指标草案清晰度和相关性的看法。小组成员对每项指标草案的清晰度和相关性分别按4级评分。事先规定清晰度和相关性的CVI得分≥0.78表示达成一致并完成指标制定。
小组成员认为5项疲劳风险管理绩效指标清晰且相关。这些指标涉及疲劳和/或嗜睡调查工具的使用、最佳轮班时长、获取咖啡因作为抗疲劳措施、轮班工作期间的小憩使用情况，以及为EMS人员提供疲劳风险管理教育和培训。小组成员还为EMS机构的实施提出了建议，对绩效指标进行了补充。
EMS环境中疲劳风险管理的绩效指标将促进EMS疲劳循证指南的实施和评估。
