Real-time tablet-based resuscitation documentation by the team leader: evaluating documentation quality and clinical performance

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.

Cardiopulmonary resuscitation of adults with in-hospital cardiac arrest using the Utstein style

“…To correctly fill out reports and subsequently analyze adherence to CPR guidelines, real-time documentation by an attending professional using a tablet may improve data quality and accuracy without compromising team performance. (32) …”

Rating the quality of teamwork—a comparison of novice and expert ratings using the Team Emergency Assessment Measure (TEAM) in simulated emergencies

“…Fung and colleagues suggested that the lack of an objective measurement of team performance is one reason for this paucity of data [15]. While, for example, chest compression rate and depth can nowadays be tracked [16] and technical solutions help to document resuscitations more precisely [17], teamwork behaviour is not easy to measure, especially in real-life situations. Such information is not only relevant for research but also a necessity to inform debriefings after resuscitation [18].…”

Accuracy of real-time delivery room resuscitation documentation

“…Although accurate recording of delivery room resuscitation is important for complete medical documentation, research and quality assurance initiatives, resuscitation documentation is often incomplete and/or inaccurate 2–4. Schilleman et al reported that retrospective documentation accurately reflected the mode of respiratory support in 83%, FiO 2 use in 57% and initial HR assessment in 37% delivery room resuscitations 2.…”

“…Video recording captures more objective and consistent information than both retrospective and in-person documentation 2–4. However, technical and implementation barriers limit the reliability of video recording,5 as evident by the seven resuscitations excluded from our study due to incomplete recordings.…”