Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol
Introduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM)—a collection of crisis checklists—improves management of clinical...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e071545.full |
| _version_ | 1797640856927207424 |
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| author | Ulf Ekelund Eric Dryver Anders Bergenfelz Pontus Olsson de Capretz Mohammed Mohammad Malin Armelin William D. Dupont |
| author_facet | Ulf Ekelund Eric Dryver Anders Bergenfelz Pontus Olsson de Capretz Mohammed Mohammad Malin Armelin William D. Dupont |
| author_sort | Ulf Ekelund |
| collection | DOAJ |
| description | Introduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM)—a collection of crisis checklists—improves management of clinical perioperative crises. There is a need for in-depth prospective studies of EM use during clinical practice, evaluating when and how EMs are used and impact on patient management.Methods and analysis This 6-month long study prospectively evaluates a digital EM during management of priority 1 patients in the Skåne University Hospital at Lund’s ED. Resuscitation teams are encouraged to use the EM after a management plan has been derived (‘Do-Confirm’). The documenting nurse activates and reads from the EM, and checklists are displayed on a large screen visible to all team members. Whether the EM is activated, and which sections are displayed, are automatically recorded. Interventions performed thanks to Do-Confirm EM use are registered by the nurse. Fifty cases featuring such interventions are reviewed by specialists in emergency medicine blinded to whether the interventions were performed prior to or after EM use. All interventions are graded as indicated, of neutral relevance or not indicated. The primary outcome measures are the proportions of interventions performed thanks to Do-Confirm EM use graded as indicated, of neutral relevance, and not indicated. A secondary outcome measure is the team’s subjective evaluation of the EM’s value on a Likert scale of 1–6. Team members can report events related to EM use, and information from these events is extracted through structured interviews.Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Dnr 2022-01896-01). Results will be published in a peer-reviewed journal and abstracts submitted to national and international conferences to disseminate our findings.Trial registration number NCT05649891. |
| first_indexed | 2024-03-11T13:37:06Z |
| format | Article |
| id | doaj.art-209d2200429d41a4916ad3d4742e049e |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T13:37:06Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-209d2200429d41a4916ad3d4742e049e2023-11-02T15:30:07ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2022-071545Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocolUlf Ekelund0Eric Dryver1Anders Bergenfelz2Pontus Olsson de Capretz3Mohammed Mohammad4Malin Armelin5William D. Dupont6Department of Emergency and Internal Medicine, Skåne University Hospital Lund, Lund, SwedenDepartment of Emergency and Internal Medicine, Skåne University Hospital Lund, Lund, SwedenDepartment of Clinical Sciences at Lund, Lund University, Lund, SwedenDepartment of Emergency and Internal Medicine, Skåne University Hospital Lund, Lund, SwedenDepartment of Emergency and Internal Medicine, Skåne University Hospital Lund, Lund, SwedenDepartment of Emergency and Internal Medicine, Skåne University Hospital Lund, Lund, SwedenDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USAIntroduction Simulation-based studies indicate that crisis checklist use improves management of patients with critical conditions in the emergency department (ED). An interview-based study suggests that use of an emergency manual (EM)—a collection of crisis checklists—improves management of clinical perioperative crises. There is a need for in-depth prospective studies of EM use during clinical practice, evaluating when and how EMs are used and impact on patient management.Methods and analysis This 6-month long study prospectively evaluates a digital EM during management of priority 1 patients in the Skåne University Hospital at Lund’s ED. Resuscitation teams are encouraged to use the EM after a management plan has been derived (‘Do-Confirm’). The documenting nurse activates and reads from the EM, and checklists are displayed on a large screen visible to all team members. Whether the EM is activated, and which sections are displayed, are automatically recorded. Interventions performed thanks to Do-Confirm EM use are registered by the nurse. Fifty cases featuring such interventions are reviewed by specialists in emergency medicine blinded to whether the interventions were performed prior to or after EM use. All interventions are graded as indicated, of neutral relevance or not indicated. The primary outcome measures are the proportions of interventions performed thanks to Do-Confirm EM use graded as indicated, of neutral relevance, and not indicated. A secondary outcome measure is the team’s subjective evaluation of the EM’s value on a Likert scale of 1–6. Team members can report events related to EM use, and information from these events is extracted through structured interviews.Ethics and dissemination The study is approved by the Swedish Ethical Review Authority (Dnr 2022-01896-01). Results will be published in a peer-reviewed journal and abstracts submitted to national and international conferences to disseminate our findings.Trial registration number NCT05649891.https://bmjopen.bmj.com/content/13/10/e071545.full |
| spellingShingle | Ulf Ekelund Eric Dryver Anders Bergenfelz Pontus Olsson de Capretz Mohammed Mohammad Malin Armelin William D. Dupont Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol BMJ Open |
| title | Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol |
| title_full | Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol |
| title_fullStr | Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol |
| title_full_unstemmed | Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol |
| title_short | Clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department: a prospective mixed-methods study protocol |
| title_sort | clinical use of an emergency manual by resuscitation teams and impact on performance in the emergency department a prospective mixed methods study protocol |
| url | https://bmjopen.bmj.com/content/13/10/e071545.full |
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