Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Decision support system in prehospital care: a randomized controlled simulation study
Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
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.
Visa övriga samt affilieringar
2013 (Engelska)Ingår i: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 31, nr 1, s. 145-153Artikel i tidskrift (Refereegranskat) 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.

Ort, förlag, år, upplaga, sidor
2013. Vol. 31, nr 1, s. 145-153
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
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
Tillgänglig från: 2012-01-15 Skapad: 2012-01-15 Senast uppdaterad: 2018-03-16Bibliografiskt granskad
Ingår i avhandling
1. Development and Evaluation of a Computerised Decision Support System for use in pre-hospital care
Öppna denna publikation i ny flik eller fönster >>Development and Evaluation of a Computerised Decision Support System for use in pre-hospital care
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Jönköping: School of Health Sciences, 2014. s. 92
Serie
Dissertation Series. School of Health Sciences, ISSN 1654-3602 ; 52
Nyckelord
prehospital care, patient assessment, clinical judgment, decision making, patient safety, human error, decision support
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:hj:diva-23781 (URN)978-91-85835-51-5 (ISBN)
Disputation
2014-06-05, M 204, Högskolan i Borås, Borås, 13:00
Opponent
Handledare
Tillgänglig från: 2014-05-12 Skapad: 2014-05-12 Senast uppdaterad: 2014-05-12Bibliografiskt granskad

Open Access i DiVA

Fulltext saknas i DiVA

Övriga länkar

Förlagets fulltextPubMedScopus

Personposter BETA

Hagiwara, MagnusHenricson, Maria

Sök vidare i DiVA

Av författaren/redaktören
Hagiwara, MagnusHenricson, Maria
Av organisationen
HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärdHHJ, Avd. för omvårdnadHHJ. ADULT
I samma tidskrift
American Journal of Emergency Medicine
Medicin och hälsovetenskap

Sök vidare utanför DiVA

GoogleGoogle Scholar

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 609 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf