Clinical utility of a targeted smartphone application to aid veterinary students in calculating constant rate infusions and perioperative fluid drip rates

Abstract

BackgroundTo compare the utility of a targeted smartphone application (TSPA) with a non-programmable calculator (NPC) when calculating fluid drip rates (FDR) and constant rate infusions (CRIs).MethodsIn a prospective randomised clinical study, 48 fourth-year veterinary students entered one of four parallel groups involving two mock scenarios: fentanyl calculation using an NPC followed by lidocaine calculation using a TSPA, fentanyl (TSPA) followed by lidocaine (NPC), lidocaine (NPC) followed by fentanyl (TSPA) or lidocaine (TSPA) followed by fentanyl (NPC). Students calculated volume of drug added to maintenance fluids and drops/second that correctly administered the drug dose and FDR. Time to completion was assessed using an analysis of variance. A Fisher’s exact test assessed the effect of study period, scenario and device in the proportion of correct/incorrect answers.ResultsParticipants took longer to complete the scenarios in period 1 and 2 with the NPC (380.7±195.6 seconds and 488±154.8 seconds, respectively) than the TSPA (247.5±88.8 seconds and 224±94.2 seconds, respectively) (P<0.0031 and P<0.0001). Participants were more likely to complete the scenarios incorrectly with the NPC (n=32) when compared with the TSPA (n=7) (P<0.0001).ConclusionsTSPAs are more efficient and accurate when calculating CRIs and FDR compared with conventional methods. Medical mathematics must be emphasised during the veterinary curriculum.

Incidence and type of voluntary reported perianesthetic medication errors in community veterinary clinics in Calgary, Canada

“…Calculation errors occur mainly from unit conversion errors (eg, mg to mcg) and errors when multiplying or dividing. 24 Evidence from physician prescriptions identified calculation errors as stemming from insufficient basic mathematical skills. 25 This may highlight a critical gap in healthcare practitioner course curricula: the need for teaching and assessing drug calculation skills.…”

“…In human pediatric practice, it is reported that 85% (35/41) of anesthetists were unable to calculate a dopamine infusion for a pediatric patient. 27 As a strategy to reduce calculation errors, smartphone applications have been described as being successful in facilitating anesthesia management and reducing errors by veterinary students 24 and human anesthesia providers. 28 Additionally, automated dose calculation tools exist and may represent an accessible option for veterinary patients.…”

The case for quality improvement in veterinary medicine

“…The use of technology, including electronic prescribing and smart infusion pumps, has substantially improved medication safety in human medicine 23 . Similarly, in 1 veterinary study, medication dosing errors were reduced by 52% when veterinary students used a targeted smartphone application instead of a calculator to determine continuous infusion and fluid drip rates 24 . These are promising outcomes that should not only be disseminated across the profession for broader adoption, but also invested in to further mitigate safety risks in veterinary environments.…”