Emergency Department, Department of Interdisciplinary Centres, Lausanne University Hospital, Lausanne, Vaud, Switzerland
Medicine, REGA, Zurich, Switzerland.
BMJ Open. 2024 Mar 7;14(3):e081951. doi: 10.1136/bmjopen-2023-081951.
We aimed to determine the feasibility of quality indicators (QIs) for prehospital advanced airway management (PAAM) from a provider point of view.
The study is a survey based feasibility assessment following field testing of QIs for PAAM.
The study was performed in two physician staffed emergency medical services in Switzerland.
42 of the 44 emergency physicians who completed at least one case report form (CRF) dedicated to the collection of the QIs on PAAM between 1 January 2019 and 31 December 2021 participated in the study.
The data required to calculate the 17 QIs was systematically collected through a dedicated electronic CRF.
Primary outcomes were provider-related feasibility criteria: relevance and acceptance of the QIs, as well as reliability of the data collection. Secondary outcomes were effort to collect specific data and to complete the CRF.
Over the study period, 470 CRFs were completed, with a median of 11 per physician (IQR 4-17; range 1-48). The median time to complete the CRF was 7 min (IQR 3-16) and was considered reasonable by 95% of the physicians. Overall, 75% of the physicians assessed the set of QIs to be relevant, and 74% accepted that the set of QIs assessed the quality of PAAM. The reliability of data collection was rated as good or excellent for each of the 17 QIs, with the lowest rated for the following 3 QIs: duration of preoxygenation, duration of laryngoscopy and occurrence of desaturation during laryngoscopy.
Collection of QIs on PAAM appears feasible. Electronic medical records and technological solutions facilitating automatic collection of vital parameters and timing during the procedure could improve the reliability of data collection for some QIs. Studies in other services are needed to determine the external validity of our results.
我们旨在从提供者的角度确定院前高级气道管理（PAAM）质量指标（QI）的可行性。
本研究是一项基于现场测试 PAAM 的 QI 的调查性可行性评估。
该研究在瑞士的两家医生配备的紧急医疗服务机构中进行。
2019 年 1 月 1 日至 2021 年 12 月 31 日期间，至少完成了一份专门用于收集 PAAM 相关 QI 的病例报告表（CRF）的 44 名急诊医师中，有 42 名参与了该研究。
通过专门的电子 CRF 系统地收集了计算 17 个 QI 所需的数据。
主要结果是与提供者相关的可行性标准：QI 的相关性和可接受性，以及数据收集的可靠性。次要结果是收集特定数据和完成 CRF 的努力。
在研究期间，完成了 470 份 CRF，每位医生的中位数为 11 份（IQR 4-17；范围 1-48）。完成 CRF 的中位数时间为 7 分钟（IQR 3-16），95%的医生认为这是合理的。总体而言，75%的医生认为这组 QI 具有相关性，74%的医生接受这组 QI 评估 PAAM 的质量。对于 17 个 QI 中的每一个，数据收集的可靠性都被评为良好或优秀，其中评分最低的是预充氧时间、喉镜检查时间和喉镜检查期间发生的饱和度下降。
PAAM 的 QI 收集似乎是可行的。电子病历和技术解决方案，可以方便地在手术过程中自动收集重要参数和时间，这可以提高一些 QI 的数据收集可靠性。需要在其他服务中进行研究，以确定我们结果的外部有效性。
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