Evidence map›Paper›PMID 31915029›Full record

Trial reportHuman resources for health2020

Do cognitive aids reduce error rates in resuscitation team performance? Trial of emergency medicine protocols in simulation training (TEMPIST) in Australia.

Charlotte Hall, Dean Robertson, Margaret Rolfe, Sharene Pascoe, Megan E Passey, Sabrina Winona Pit

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Human resources for health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Charlotte HallUniversity Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, Lismore, NSW, 2480, Australia. charlotte.hall@health.nsw.gov.au.
Dean RobertsonMaclean District Hospital, Maclean, NSW, Australia.
Margaret RolfeSchool of Rural Health, The University of Sydney, University Centre for Rural Health, Lismore, Australia.
Sharene PascoeSchool of Rural Health, The University of Sydney, University Centre for Rural Health, Lismore, Australia.
Megan E PasseySchool of Rural Health, The University of Sydney, University Centre for Rural Health, Lismore, Australia.
Sabrina Winona PitUniversity Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, Lismore, NSW, 2480, Australia. s.pit@westernsydney.edu.au.ORCID 0000-0003-2410-0703

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResuscitation of patients with time-critical and life-threatening illness represents a cognitive challenge for emergency room (ER) clinicians. We designed a cognitive aid, the Emergency Protocols Handbook, to simplify clinical management and team processes. Resuscitation guidelines were reformatted into simple, single step-by-step pathways. This Australian randomised controlled trial tested the effectiveness of this cognitive aid in a simulated ER environment by observing team error rates when current resuscitation guidelines were followed, with and without the handbook.

methodsResuscitation teams were randomised to manage two scenarios with the handbook and two without in a high-fidelity simulation centre. Each scenario was video-recorded. The primary outcome measure was error rates (the number of errors made out of 15 key tasks per scenario). Key tasks varied by scenario. Each team completed four scenarios and was measured on 60 key tasks. Participants were surveyed regarding their perception of the usefulness of the handbook.

resultsTwenty-one groups performed 84 ER crisis simulations. The unadjusted error rate in the handbook group was 18.8% (121/645) versus 38.9% (239/615) in the non-handbook group. There was a statistically significant reduction of 54.0% (95% CI 49.9-57.9) in the estimated percentage error rate when the handbook was available across all scenarios 17.9% (95% CI 14.4-22.0%) versus 38.9% (95% CI 34.2-43.9%). Almost all (97%) participants said they would want to use this cognitive aid during a real medical crisis situation.

conclusionThis trial showed that by following the step-by-step, linear pathways in the handbook, clinicians more than halved their teams' rate of error, across four simulated medical crises. The handbook improves team performance and enables healthcare teams to reduce clinical error rates and thus reduce harm for patients.

trial registrationACTRN12616001456448 registered: www.anzctr.org.au. Trial site: http://emergencyprotocols.org.au/.

Indexed as

Decision Support TechniquesSimulation TrainingAustraliaCritical CareFemaleHumansMaleOutcome Assessment, Health CarePatient Care TeamResuscitationSurveys and QuestionnairesChecklistsCognitive aidsCrisis error ratesEmergency crisisEmergency departmentEmergency roomGuidelinesNon-technical skillsPatient safetyResuscitationSimulation trainingTeam performance

Identifiers

PMID31915029
PMCPMC6950852

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.