Does electronic decision support influence advanced life support in simulated cardiac arrest?

Abstract

Introduction: In-hospital cardiac arrest is common but survival rates vary considerably. The reasons for this may relate to human factors. Decision support systems and tools have been suggested as a means of reducing human errors and improving outcomes. Methods: This study aimed to: investigate if an electronic decision support system (eDSS) influenced advanced life support (ALS) in a simulated in-hospital cardiac arrest scenario; and explore practitioners' views of their performance with and without the eDSS. Teams of nurses and student nurses managed two scenarios with and without using an eDSS, and their adherence to an ALS protocol was assessed. Teams then took part in group interviews. Results: Teams using the eDSS were more likely to adhere to the drug and shock administration elements of the ALS protocol but were less safe in doing so, which may have been because they were unfamiliar with it. The interviews yielded one overarching theme—team working—and three subthemes of team performance and dynamics, team leader performance and areas for development. Some considered the eDSS as a source of reassurance that supported organisation and communication, while others found it a distraction; reduced situational awareness was observed when it was used. Conclusion: While an eDSS can support practitioners managing a simulated cardiac arrest, it is important to test prototypes in extensive simulation-based situations before they are used in clinical practice.