Dataset Information

Accuracy of real-time delivery room resuscitation documentation.

ABSTRACT:

Objective

To assess the accuracy of real-time delivery room resuscitation documentation.

Design

Retrospective observational study.

Setting

Level 3 academic neonatal intensive care unit.

Participants

Fifty infants with video recording of neonatal resuscitation.

Main outcome measures

Vital sign assessments and interventions performed during resuscitation. The accuracy of written documentation was compared with video gold standard.

Results

Timing of initial heart rate assessment agreed with video in 44/50 (88%) records; the documented heart rate was correct in 34/44 (77%) of these. Heart rate and oxygen saturation were documented at 5 min of life in 90% of resuscitations. Of these, 100% of heart rate and 93% of oxygen saturation values were correctly recorded. Written records accurately reflected the mode(s) of respiratory support for 89%-100%, procedures for 91%-100% and medications for 100% of events.

Conclusion

Real-time documentation correctly reflects interventions performed during delivery room resuscitation but is less accurate for early vital sign assessments.

SUBMITTER: Fishman CE

PROVIDER: S-EPMC6534487 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Accuracy of real-time delivery room resuscitation documentation.

Fishman Claire E CE Weinberg Danielle D DD Murray Ashley A Foglia Elizabeth E EE

Archives of disease in childhood. Fetal and neonatal edition 20181124 2

<h4>Objective</h4>To assess the accuracy of real-time delivery room resuscitation documentation.<h4>Design</h4>Retrospective observational study.<h4>Setting</h4>Level 3 academic neonatal intensive care unit.<h4>Participants</h4>Fifty infants with video recording of neonatal resuscitation.<h4>Main outcome measures</h4>Vital sign assessments and interventions performed during resuscitation. The accuracy of written documentation was compared with video gold standard.<h4>Results</h4>Timing of initia ...[more]

PMID: 30472661

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Project description:BackgroundComplete documentation of critical care events in the accident and emergency department (AED) is essential. Due to the fast-paced and complex nature of resuscitation cases, missing data is a common issue during emergency situations.ObjectiveThis study aimed to evaluate the impact of a tablet-based resuscitation record on documentation completeness during medical resuscitations and nurses' perceptions of the use of the tablet app.MethodsA mixed methods approach was adopted. To collect quantitative data, randomized retrospective reviews of paper-based resuscitation records before implementation of the tablet (Pre-App Paper; n=176), paper-based resuscitation records after implementation of the tablet (Post-App Paper; n=176), and electronic tablet-based resuscitation records (Post-App Electronic; n=176) using a documentation completeness checklist were conducted. The checklist was validated by 4 experts in the emergency medicine field. The content validity index (CVI) was calculated using the scale CVI (S-CVI). The universal agreement S-CVI was 0.822, and the average S-CVI was 0.939. The checklist consisted of the following 5 domains: basic information, vital signs, procedures, investigations, and medications. To collect qualitative data, nurses' perceptions of the app for electronic resuscitation documentation were obtained using individual interviews. Reporting of the qualitative data was guided by Consolidated Criteria for Reporting Qualitative Studies (COREQ) to enhance rigor.ResultsA significantly higher documentation rate in all 5 domains (ie, basic information, vital signs, procedures, investigations, and medications) was present with Post-App Electronic than with Post-App Paper, but there were no significant differences in the 5 domains between Pre-App Paper and Post-App Paper. The qualitative analysis resulted in main categories of "advantages of tablet-based documentation of resuscitation records," "challenges with tablet-based documentation of resuscitation records," and "areas for improvement of tablet-based resuscitation records."ConclusionsThis study demonstrated that higher documentation completion rates are achieved with electronic tablet-based resuscitation records than with traditional paper records. During the transition period, the nurse documenters faced general problems with resuscitation documentation such as multitasking and unique challenges such as software updates and a need to familiarize themselves with the app's layout. Automation should be considered during future app development to improve documentation and redistribute more time for patient care. Nurses should continue to provide feedback on the app's usability and functionality during app refinement to ensure a successful transition and future development of electronic documentation records.

Project description:ObjectiveTo investigate whether real-time audio and visual feedback during cardiopulmonary resuscitation outside hospital increases the proportion of subjects who achieved prehospital return of spontaneous circulation.DesignA cluster-randomised trial.Subjects1586 people having cardiac arrest outside hospital in whom resuscitation was attempted by emergency medical services (771 procedures without feedback, 815 with feedback).SettingEmergency medical services from three sites within the Resuscitation Outcomes Consortium in the United States and Canada.InterventionReal-time audio and visual feedback on cardiopulmonary resuscitation (CPR) provided by the monitor-defibrillator.Main outcome measurePrehospital return of spontaneous circulation after CPR.ResultsBaseline patient and emergency medical service characteristics did not differ between groups. Emergency medical services muted the audible feedback in 14% of cases during the period with feedback. Compared with CPR clusters lacking feedback, clusters assigned to feedback were associated with increased proportion of time in which chest compressions were provided (64% v 66%, cluster-adjusted difference 1.9 (95% CI 0.4 to 3.4)), increased compression depth (38 v 40 mm, adjusted difference 1.6 (0.5 to 2.7)), and decreased proportion of compressions with incomplete release (15% v 10%, adjusted difference -3.4 (-5.2 to -1.5)). However, frequency of prehospital return of spontaneous circulation did not differ according to feedback status (45% v 44%, adjusted difference 0.1% (-4.4% to 4.6%)), nor did the presence of a pulse at hospital arrival (32% v 32%, adjusted difference -0.8 (-4.9 to 3.4)), survival to discharge (12% v 11%, adjusted difference -1.5 (-3.9 to 0.9)), or awake at hospital discharge (10% v 10%, adjusted difference -0.2 (-2.5 to 2.1)).ConclusionsReal-time visual and audible feedback during CPR altered performance to more closely conform with guidelines. However, these changes in CPR performance were not associated with improvements in return of spontaneous circulation or other clinical outcomes. Trial Registration Clinical Trials NCT00539539.

Dataset Information

Accuracy of real-time delivery room resuscitation documentation.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Accuracy of real-time delivery room resuscitation documentation.

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