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Decision Support Tool in Prehospital Care: A systematic Review of Randomized Trials
University of Borås, School of Health Sciences, Borås, Sweden.
Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
University of Borås, School of Health Sciences.
University of Borås, School of Health Sciences.
2011 (Engelska)Ingår i: Prehospital and Disaster Medicine, ISSN 1049-023X, Vol. 26, nr 5, s. 319-329Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient.

Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials.

Results: Use of the DST in prehospital care may have the possibility to decrease “time to definitive care” and improve diagnostic accuracy among prehospital personnel, but more studies are needed.

Conclusions: The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care.

Ort, förlag, år, upplaga, sidor
2011. Vol. 26, nr 5, s. 319-329
Nyckelord [en]
Prehospital decision support tool, prehospital care, emergency medical services, emergency medical technician
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:hj:diva-17143DOI: 10.1017/S1049023X11006534OAI: oai:DiVA.org:hj-17143DiVA, id: diva2:478092
Tillgänglig från: 2012-01-15 Skapad: 2012-01-15 Senast uppdaterad: 2014-05-12Bibliografiskt 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

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Hagiwara, MagnusHenricson, Maria

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