Abstract
BackgroundPrecise and complete documentation of in-hospital cardiopulmonary resuscitations is important but data quality can be poor. In the present study, we investigated the effect of a tablet-based application for real-time resuscitation documentation used by the emergency team leader on documentation quality and clinical performance of the emergency team.MethodsSenior anaesthesiologists either used the tablet-based application during the simulated resuscitation for documentation and also used the application for the final documentation or conducted the full documentation at the end of the scenario using the local hospital information system. The latter procedure represents the current local documentation method. All scenarios were video recorded. To assess the documentation, we compared the precision of intervention delivery times, documentation completeness, and final documentation time. To assess clinical performance, we compared adherence to guidelines for defibrillation and adrenaline administration, the no-flow fraction, and the time to first defibrillation.ResultsThe results showed significant benefits for the tablet-based application compared to the hospital information system for precision of the intervention delivery times, the final documentation time, and the no-flow fraction. We observed no differences between the groups for documentation completeness, adherence to guidelines for defibrillation and adrenaline administration, and the time to first defibrillation.DiscussionIn the presented study, we observed that a tablet-based application can improve documentation data quality. Furthermore, we demonstrated that a well-designed application can be used in real-time by a member of the emergency team with possible beneficial effects on clinical performance.ConclusionThe present evaluation confirms the advantage of tablet-based documentation tools and also shows that the application can be used by an active member of an emergency team without compromising clinical performance.
Highlights
Precise and complete documentation of in-hospital cardiopulmonary resuscitations is important but data quality can be poor
The present evaluation confirms the advantage of tablet-based documentation tools and shows that the application can be used by an active member of an emergency team without compromising clinical performance
Data analysis To assess intervention delivery times and completeness, we considered the following six interventions: start of emergency, arrival at patient, start of cardiopulmonary resuscitation, 1st defibrillation, 1st adrenaline administration, and intubation
Summary
Precise and complete documentation of in-hospital cardiopulmonary resuscitations is important but data quality can be poor. Precise and complete documentation of cardiopulmonary resuscitations is important for quality improvement [1], medicolegal reasons [2], and research [3]. Data such as the time to first defibrillation are used to predict survival rates of in-hospital cardiac arrest [4] and benchmarking and improving out-of-hospital cardiac arrests outcomes in Europe [5]. Previous studies used information technology to improve the data quality of in-hospital cardiac arrests [7, 11,12,13,14,15].
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