Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Decision support system in prehospital care: a randomized controlled simulation study
Jönköping University, School of Health and Welfare, HHJ, Quality Improvement and Leadership in Health and Welfare.
Department of Signals and Systems, Chalmers University of Technology, Gothenburg, .
School of Health Sciences, University of Borås, Borås, Sweden.
School of Health Sciences, University of Borås, Borås, Sweden.
Show others and affiliations
2013 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 31, no 1, p. 145-153Article in journal (Refereed) Published
Abstract [en]

Introduction: Prehospital emergency medicine is a challenging discipline characterized by a high level of acuity, a lack of clinical information and a wide range of clinical conditions. These factors contribute to the fact that prehospital emergency medicine is a high-risk discipline in terms of medical errors. Prehospital use of Computerized Decision Support System (CDSS) may be a way to increase patient safety but very few studies evaluate the effect in prehospital care. The aim of the present study is to evaluate a CDSS.

Methods: In this non-blind block randomized, controlled trial, 60 ambulance nurses participated, randomized into 2 groups. To compensate for an expected learning effect the groups was further divided in two groups, one started with case A and the other group started with case B. The intervention group had access to and treated the two simulated patient cases with the aid of a CDSS. The control group treated the same cases with the aid of a regional guideline in paper format. The performance that was measured was compliance with regional prehospital guidelines and On Scene Time (OST).

Results: There was no significant difference in the two group's characteristics. The intervention group had a higher compliance in the both cases, 80% vs. 60% (p < 0.001) but the control group was complete the cases in the half of the time compare to the intervention group (p < 0.001).

Conclusion: The results indicate that this CDSS increases the ambulance nurses' compliance with regional prehospital guidelines but at the expense of an increase in OST.

Place, publisher, year, edition, pages
2013. Vol. 31, no 1, p. 145-153
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-17142DOI: 10.1016/j.ajem.2012.06.030ISI: 000312954600022PubMedID: 23000323Scopus ID: 2-s2.0-84870905830OAI: oai:DiVA.org:hj-17142DiVA, id: diva2:478088
Available from: 2012-01-15 Created: 2012-01-15 Last updated: 2018-03-16Bibliographically approved
In thesis
1. Development and Evaluation of a Computerised Decision Support System for use in pre-hospital care
Open this publication in new window or tab >>Development and Evaluation of a Computerised Decision Support System for use in pre-hospital care
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of the thesis was to develop and evaluate a Computerised Decision Support System (CDSS) for use in pre-hospital care.

The thesis was guided by a theoretical framework for developing and evaluating a complex intervention. The four studies used different designs and methods. The first study was a systematic review of randomised controlled trials. The second and the last studies had experimental and quasi-experimental designs, where the CDSS was evaluated in a simulation setting and in a clinical setting. The third study included in the thesis had a qualitative case study design.

The main findings from the studies in the thesis were that there is a weak evidence base for the use of CDSS in pre-hospital care. No studies have previously evaluated the effect of CDSS in pre-hospital care. Due to the context, pre-hospital care is dependent on protocol-based care to be able to deliver safe, high-quality care. The physical format of the current paper based guidelines and protocols are the main obstacle to their use. There is a request for guidelines and protocols in an electronic format among both clinicians and leaders of the ambulance organisations. The use of CDSS in the pre-hospital setting has a positive effect on compliance with pre-hospital guidelines. The largest effect is in the primary survey and in the anamnesis of the patient. The CDSS also increases the amount of information collected in the basic pre-hospital assessment process. The evaluated CDSS had a limited effect on on-the-scene time.

The developed and evaluated CDSS has the ability to increase pre-hospital patient safety by reducing the risks of cognitive bias. Standardising the assessment process, enabling explicit decision support in the form of checklists, assessment rules, differential diagnosis lists and rule out worst-case scenario strategies, reduces the risk of premature closure in the assessment of the pre-hospital patient.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2014. p. 92
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 52
Keywords
prehospital care, patient assessment, clinical judgment, decision making, patient safety, human error, decision support
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-23781 (URN)978-91-85835-51-5 (ISBN)
Public defence
2014-06-05, M 204, Högskolan i Borås, Borås, 13:00
Opponent
Supervisors
Available from: 2014-05-12 Created: 2014-05-12 Last updated: 2014-05-12Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textPubMedScopus

Authority records BETA

Hagiwara, MagnusHenricson, Maria

Search in DiVA

By author/editor
Hagiwara, MagnusHenricson, Maria
By organisation
HHJ, Quality Improvement and Leadership in Health and WelfareHHJ, Dep. of Nursing ScienceHHJ. ADULT
In the same journal
American Journal of Emergency Medicine
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 591 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf