EVALUATION OF DOCUMENTATION QUALITY AND CLINICAL PERFORMANCE THROUGH REAL-TIME TABLET-BASED CARDIAC ARREST RESUSCITATION DOCUMENTATION
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Date
2024-09-03
Authors
Talbishi, Nouraldin
Journal Title
Journal ISSN
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Publisher
An-Najah National University
Abstract
Background: Traditional paper-based resuscitation documentations are well known for their lack of accuracy, often failing to capture the requisite level of details needed for appropriate documentation of a rapid cardiopulmonary resuscitation (CPR). The objective of this study was to assess the sensitivity and time discrepancy of a real-time tablet-based cardiac arrest resuscitation documentation application compared to the traditional paper-based resuscitation documentation. Additionally, the study also assessed the effect of using a metronome on meeting the recommended number of compressions while performing CPR.
Methods: The study was conducted at Bethlehem University's Clinical Simulation and Life Support Center and An-Najah National University's Life Support Training Center. Cardiac arrest situations were simulated during Advanced Cardiovascular Life Support (ACLS) training courses for which the study team (n = 72 participants) started a rapid ACLS scenario that consisted of 25 sequential steps/events that were based on the Adult Cardiac Arrest Algorithm of the American Heart Association (AHA). Each step/event was documented using the traditional paper-based resuscitation documentation method and the real-time tablet-based cardiac arrest resuscitation documentation application. The sensitivity and time discrepancy of the two methods in documenting CPR steps/events, ventricular fibrillation (VF), defibrillations/shocks, medication administrations, and return of spontaneous circulation (ROSC) were compared.
Results: This study evaluates the effectiveness of a real-time tablet-based cardiac arrest resuscitation documentation application compared to the traditional paper-based method during Advanced Cardiovascular Life Support (ACLS) scenarios. The tablet-based method demonstrated significantly greater sensitivity in accurately documenting key resuscitation events, including CPR pauses, defibrillation, medication administration, and cardiac rhythms (p-values ranging from <0.001 to 0.031). Furthermore, time discrepancies in documenting 25 critical events were significantly reduced when using the tablet-based application (p < 0.001). Additionally, the use of a metronome was strongly associated with achieving the recommended number of chest compressions (p < 0.001). These findings suggest that the tablet-based system enhances the precision and timeliness of resuscitation documentation, potentially improving clinical outcomes in cardiac arrest management.
Conclusions: The findings of this study showed that using the real-time tablet-based cardiac arrest resuscitation documentation application improved the accuracy, sensitivity, and timeliness of resuscitation documentation compared to traditional paper-based methods. Similarly, the use of a metronome improved meeting the recommended compression rates while performing CPR. These findings indicated that the use of digital tools can improve the quality of emergency care. The findings highlight the importance of integrating modern and innovative technologies in ACLS and CPR practices. Improving documentation practices can allow healthcare providers and decision-makers to identify and address local challenges in emergency care practice and improve the outcomes of the patients.
Keywords: Cardiopulmonary resuscitation, Cardiac arrest documentation, Code sheet, Tablet applications