• Reg Anesth Pain Med · Jul 2014

    Randomized Controlled Trial

    Adherence to guidelines for the management of local anesthetic systemic toxicity is improved by an electronic decision support tool and designated "reader".

    • Matthew D McEvoy, William R Hand, W David Stoll, Cory M Furse, and Paul J Nietert.
    • From the *Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN; †Departments of Anesthesia and Perioperative Medicine, and ‡Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, Charleston, SC.
    • Reg Anesth Pain Med. 2014 Jul 1; 39 (4): 299-305.

    Background And ObjectivesA hardcopy or paper cognitive aid has been shown to improve performance during the management of simulated local anesthetic systemic toxicity (LAST) when given to the team leader. However, there remains room for improvement to ensure a system that can achieve perfect adherence to the published guidelines for LAST management. Recent research has shown that implementing a checklist via a designated reader may be of benefit. Accordingly, we sought to investigate the effect of an electronic decision support tool (DST) and designated "Reader" role on team performance during an in situ simulation of LAST.MethodsParticipants were randomized to Reader + DST (n = 16, rDST) and Control (n = 15, memory alone). The rDST group received the assistance of a dedicated Reader on the response team who was equipped with an electronic DST. The primary outcome measure was adherence to guidelines.ResultsFor overall and critical percent correct scores, the rDST group scored higher than Control (99.3% vs 72.2%, P < 0.0001; 99.5% vs 70%, P < 0.0001, respectively). In the LAST scenario, 0 (0%) of 15 in the control group performed 100% of critical management steps, whereas 15 (93.8%) of 16 in the rDST group did so (P < 0.0001).ConclusionsIn a prospective, randomized single-blinded study, a designated Reader with an electronic DST improved adherence to guidelines in the management of an in situ simulation of LAST. Such tools are promising in the future of medicine, but further research is needed to ensure the best methods for implementing them in the clinical arena.

      Pubmed     Full text   Copy Citation  

      Add institutional full text...

    This article appears in the collection: Decision support tools in anesthesia.

    Notes

    comment
    1

    Why does any study with the words 'adherence' and 'guideline' in the same sentence immediately get my back up. If its a guideline you dont need to ADHERE to it. Think about it, follow it, maybe, but not ADHERE. Grrrrrrrr

    Allan Palmer  Allan Palmer
     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…

Want more great medical articles?

Keep up to date with a free trial of metajournal, personalized for your practice.
988,657 articles already indexed!

We guarantee your privacy. Your email address will not be shared.