Department of Emergency Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Scand J Trauma Resusc Emerg Med. 2023 Nov 21;31(1):83. doi: 10.1186/s13049-023-01150-5.
Prehospital emergency care is complex and influenced by various factors, leading to the need for decision-support tools. Studies suggest that cognitive aids improve provider performance and patient outcomes in clinical emergencies. Electronic cognitive aids have rarely been investigated in prehospital care. Therefore, this study aimed to evaluate the effects of the electronic field protocol (eFP) module on performance, adherence to the standard of care, and satisfaction of prehospital care providers in a simulated environment.
This randomised simulation-based study was conducted at the Lithuanian University of Health Sciences in Kaunas, Lithuania. The simulation scenarios were developed to test 12 eFPs: adult resuscitation, pediatric resuscitation, delivery and postpartum care, seizures in pregnancy, stroke, anaphylaxis, acute chest pain, acute abdominal pain, respiratory distress in children, severe trauma, severe infection and sepsis, and initial neonatal evaluation and resuscitation. Sixteen prehospital practitioners with at least 3 years of clinical experience were randomly assigned to either use the eFP module or perform without it in each of the 12 simulated scenarios. Participant scores and adherence to standardised checklists were compared between the two performance modes. Participant satisfaction was measured through a post-simulation survey.
A total of 190 simulation sessions were conducted. Compared to the use of memory alone, the use of the eFP module significantly improved participants' performance in 10 out of the 12 simulation scenarios. Adherence to the standardised checklist increased from 60 to 85% (p < 0.001). Post-simulation survey results indicate that participants found the eFP module easy to use and relevant to prehospital clinical practice.
The study findings suggest that the eFP module as a cognitive aid can enhance prehospital practitioners' performance and adherence to the standard of care in simulated scenarios. These results highlight the potential of standardised eFPs as a quality improvement step in prehospital care in Lithuania.
院前急救工作复杂，受多种因素影响，需要决策支持工具。研究表明，认知辅助工具可提高临床急救医护人员的表现和患者的预后。电子认知辅助工具在院前急救中很少被研究。因此，本研究旨在评估电子现场协议（eFP）模块对模拟环境中院前急救医护人员表现、对护理标准的依从性和满意度的影响。
这是一项在立陶宛考纳斯立陶宛健康科学大学进行的随机模拟研究。该模拟场景旨在测试 12 个 eFP：成人复苏、儿科复苏、分娩和产后护理、妊娠癫痫发作、中风、过敏反应、急性胸痛、急性腹痛、儿童呼吸窘迫、严重创伤、严重感染和败血症以及新生儿初步评估和复苏。16 名具有至少 3 年临床经验的院前从业者被随机分配到在每个模拟场景中使用或不使用 eFP 模块。比较了两种表现模式下参与者的得分和对标准化检查表的依从性。通过模拟后调查测量参与者的满意度。
共进行了 190 次模拟。与单独使用记忆相比，在 12 个模拟场景中的 10 个场景中，使用 eFP 模块可显著提高参与者的表现。对标准化检查表的依从性从 60%增加到 85%（p<0.001）。模拟后调查结果表明，参与者认为 eFP 模块易于使用且与院前临床实践相关。
研究结果表明，作为认知辅助工具的 eFP 模块可以提高模拟场景中院前急救医护人员的表现和对护理标准的依从性。这些结果强调了标准化 eFP 作为立陶宛院前急救质量改进步骤的潜力。
