The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.

BACKGROUND:Excessive workload may impair patient safety. However, little is known about emergency care providers' workload during the treatment of life-threatening cases including cardiopulmonary resuscitation (CPR). Therefore, we tested the hypothesis that subjective and physiological indicato...

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Main Authors: Frederick Schneider, Jan Martin, Gerhard Schneider, Christian M Schulz
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6084954?pdf=render
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author Frederick Schneider
Jan Martin
Gerhard Schneider
Christian M Schulz
author_facet Frederick Schneider
Jan Martin
Gerhard Schneider
Christian M Schulz
author_sort Frederick Schneider
collection DOAJ
description BACKGROUND:Excessive workload may impair patient safety. However, little is known about emergency care providers' workload during the treatment of life-threatening cases including cardiopulmonary resuscitation (CPR). Therefore, we tested the hypothesis that subjective and physiological indicators of workload are associated with the patient's initial NACA score and that workload is particularly high during CPR. METHODS:NASA task load index (NASA-tlx) and alarm codes were obtained for 216 sorties of pre-hospital emergency medical care. Furthermore, initial NACA scores of 140 patients were extracted from the physicians' protocols. The physiological workload indicators mean heart rate (HR) and permutation entropy (PeEn) were calculated for 51 sorties of primary care. General linear mixed models were used to analyze the association of NACA scores with subjective (NASA-tlx) and physiological (mean HR, PeEn) measures of workload. RESULTS:In contrast to the physiological variables PeEn (p = 0.10) and HR (p = 0.19), the mental (p<0.001) and temporal demands (p<0.001) as well as the effort (p<0.001) and frustration (p = 0.04) subscale of the NASA-tlx were significantly associated with initial NACA scores. Compared to NACA = I, an initial NACA score of VI (representing CPR) increased workload by a mean of 389.5% (p = 0.001) in the mental and 345.9% (p<0.001) in the temporal demands, effort by a mean of 446,8% (p = 0.002) and frustration by 190.0% (p = 0.03). In line with the increase in NASA-tlx, PeEn increased by 20.6% (p = 0.01) and HR by 6.4% (p = 0.57). CONCLUSIONS:Patients' initial NACA scores are associated with subjective workload. Workload was highest during CPR.
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spelling doaj.art-245928cb5c4f467f8da2fbeee16e20422022-12-22T00:37:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01138e020221510.1371/journal.pone.0202215The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.Frederick SchneiderJan MartinGerhard SchneiderChristian M SchulzBACKGROUND:Excessive workload may impair patient safety. However, little is known about emergency care providers' workload during the treatment of life-threatening cases including cardiopulmonary resuscitation (CPR). Therefore, we tested the hypothesis that subjective and physiological indicators of workload are associated with the patient's initial NACA score and that workload is particularly high during CPR. METHODS:NASA task load index (NASA-tlx) and alarm codes were obtained for 216 sorties of pre-hospital emergency medical care. Furthermore, initial NACA scores of 140 patients were extracted from the physicians' protocols. The physiological workload indicators mean heart rate (HR) and permutation entropy (PeEn) were calculated for 51 sorties of primary care. General linear mixed models were used to analyze the association of NACA scores with subjective (NASA-tlx) and physiological (mean HR, PeEn) measures of workload. RESULTS:In contrast to the physiological variables PeEn (p = 0.10) and HR (p = 0.19), the mental (p<0.001) and temporal demands (p<0.001) as well as the effort (p<0.001) and frustration (p = 0.04) subscale of the NASA-tlx were significantly associated with initial NACA scores. Compared to NACA = I, an initial NACA score of VI (representing CPR) increased workload by a mean of 389.5% (p = 0.001) in the mental and 345.9% (p<0.001) in the temporal demands, effort by a mean of 446,8% (p = 0.002) and frustration by 190.0% (p = 0.03). In line with the increase in NASA-tlx, PeEn increased by 20.6% (p = 0.01) and HR by 6.4% (p = 0.57). CONCLUSIONS:Patients' initial NACA scores are associated with subjective workload. Workload was highest during CPR.http://europepmc.org/articles/PMC6084954?pdf=render
spellingShingle Frederick Schneider
Jan Martin
Gerhard Schneider
Christian M Schulz
The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
PLoS ONE
title The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
title_full The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
title_fullStr The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
title_full_unstemmed The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
title_short The impact of the patient's initial NACA score on subjective and physiological indicators of workload during pre-hospital emergency care.
title_sort impact of the patient s initial naca score on subjective and physiological indicators of workload during pre hospital emergency care
url http://europepmc.org/articles/PMC6084954?pdf=render
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