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"cognitive aid"

Natalie H Chan, Niraj Mistry, Douglas M Campbell
INTRODUCTION: Despite standardized neonatal resuscitation program (NRP) training, retention and adherence to the NRP algorithm remain a challenge. Cognitive aids can potentially improve acquisition and application of NRP knowledge and skills. The objective of this study was to determine whether an interactive mobile application providing audiovisual prompts, NRP Prompt, can help novice NRP providers learn the NRP algorithm more effectively and therefore improve their NRP performance. METHODS: First- and second-year residents from family medicine and obstetrics and gynecology attending NRP training were randomized into intervention and control groups...
February 25, 2019: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Anna Clebone
PURPOSE OF REVIEW: Although the overall safety of blood transfusion is high, adverse events do still occur. Much research on transfusion reactions was done in nonperioperative patients. Fortunately, important contributions to the perioperative literature have been made in the last several years, specifically in the areas of transfusion-associated circulatory overload and transfusion-related acute lung injury (TRALI). RECENT FINDINGS: An unfavorable reaction occurs in as many as 1% of transfusions overall, although the risk of death with each unit given is between 0...
April 2019: Current Opinion in Anaesthesiology
Anna Clebone, Barbara K Burian, Avery Tung
PURPOSE: Intraoperative critical events typically include vital sign instability that requires a specific and time-sensitive response. Although cognitive aids can improve clinical performance during critical events, their design may not be optimized for real-world use. For example, during a critical event, health practitioners may be familiar with the treatment pathway and only require specific information from an aid-a behaviour described as "sampling". We hypothesized that use of cognitive aids designed to facilitate sampling behaviour would reduce the time required to extract information during simulated critical events...
February 25, 2019: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Anna Clebone
PURPOSE OF REVIEW: Although the overall safety of blood transfusion is high, adverse events do still occur. Much research on transfusion reactions was done in nonperioperative patients. Fortunately, important contributions to the perioperative literature have been made in the last several years, specifically in the areas of transfusion-associated circulatory overload and transfusion-related acute lung injury (TRALI). RECENT FINDINGS: An unfavorable reaction occurs in as many as 1% of transfusions overall, although the risk of death with each unit given is between 0...
January 7, 2019: Current Opinion in Anaesthesiology
Anna Clebone, Kim M Strupp, Gina Whitney, Michael R Anderson, Jeffrey Hottle, James Fehr, Myron Yaster, Laura E Schleelein, Barbara K Burian, Jorge A Galvez, Justin L Lockman, David Polaner, Natalie R Barnett, Michael J Keane, Shashikanth Manikappa, Stephen Gleich, Robert S Greenberg, Ariel Vincent, Sarah L Oswald, Red Starks, Scott Licata
When life-threatening, critical events occur in the operating room, the fast-paced, high-distraction atmosphere often leaves little time to think or deliberate about management options. Success depends on applying a team approach to quickly implement well-rehearsed, systematic, evidence-based assessment and treatment protocols. Mobile devices offer resources for readily accessible, easily updatable information that can be invaluable during perioperative critical events. We developed a mobile device version of the Society for Pediatric Anesthesia 26 Pediatric Crisis paper checklists-the Pedi Crisis 2...
December 11, 2018: Anesthesia and Analgesia
Torin D Shear, Mark Deshur, Jessica Benson, Steven Houg, Chi Wang, Jeffrey Katz, Pam Aitchison, Peggy Ochoa, Ernest Wang, Joseph Szokol
The aim of this study was to assess the effect of a dynamic electronic cognitive aid with embedded clinical decision support (dCA) versus a static cognitive aid (sCA) tool. Anesthesia residents in clinical anesthesia years 2 and 3 were recruited to participate. Each subject was randomized to one of two groups and performed an identical simulated clinical scenario. The primary outcome was task checklist performance with a secondary outcome of performance using the Anesthesia Non-technical skills (ANTS) scoring system...
November 22, 2018: Journal of Medical Systems
Jeffrey Huang, Anamaria Parus, Jiayan Wu, Chunyuan Zhang
Background Emergency manuals (EMs) are guides that provide a sequence of procedures and are used in response to critical events in the operating room. Literature has described the clinical advantage of such cognitive aids but implementation remains a problem because habits can be difficult to change. Studies have shown that successful use of EMs can be achieved by simulation training. This form of active learning engages the participants and provides the advantage of hands-on experience. Therefore, a simulation competition, namely Simulation Wars, was established in China to promote simulation training and increase training participation...
August 23, 2018: Curēus
Aalok V Agarwala, L Kelsey McRichards, Vanessa Rao, Vanessa Kurzweil, Sara N Goldhaber-Fiebert
BACKGROUND: Emergency manuals (EMs) are context-relevant sets of crisis checklists or cognitive aids designed to enable professional teams to deliver optimal care during critical events. Evidence from simulation and other high-risk industries have proven that use of these types of checklists can significantly improve event management and decrease omissions of key steps. However, simply printing and placing tools in operating rooms (ORs) is unlikely to be effective. How interventions are implemented influences whether clinicians actually change practice and whether patient care is affected...
October 16, 2018: Joint Commission Journal on Quality and Patient Safety
Amie L Hoefnagel, Shobana Rajan, Adriana Martin, Vibha Mahendra, Amanda K Knutson, Jamie L Uejima, Guy Kositratna, Mark Weller, Hui Yang, Sanchit Ahuja, Caryl Bailey, John F Bebawy
Cognitive aids and evidence-based checklists are frequently utilized in complex situations across many disciplines and sectors. The purpose of such aids is not simply to provide instruction so as to fulfill a task, but rather to ensure that all contingencies related to the emergency are considered and accounted for and that the task at hand is completed fully, despite possible distractions. Furthermore, utilization of a checklist enhances communication to all team members by allowing all stakeholders to know and understand exactly what is occurring, what has been accomplished, and what remains to be done...
January 2019: Journal of Neurosurgical Anesthesiology
Helen Chester, Paul Clarkson, Linda Davies, Jane Hughes, Muhammad Saiful Islam, Narinder Kapur, Martin Orrell, Julie Peconi, Rosa Pitts, Fiona Poland, Ian Russell, David Challis
BACKGROUND: There is a growing need for an evidence-based approach to home support for people with dementia and their carers following diagnosis but research on the effectiveness and cost-effectiveness of different approaches is sparse. The Dementia Early Stage Cognitive Aids New Trial (DESCANT) will evaluate the clinical and cost-effectiveness of a range of memory aids, training and support to people with mild to moderate dementia and their carers at home and compares that intervention with treatment as usual...
October 10, 2018: Trials
Laura V Duggan, Peter G Brindley, J Adam Law
No abstract text is available yet for this article.
October 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Sylvia Bereknyei Merrell, David M Gaba, Aalok V Agarwala, Jeffrey B Cooper, Andrea L Nevedal, Steven M Asch, Steven K Howard, Sara N Goldhaber-Fiebert
BACKGROUND: An emergency manual (EM) is a set of evidence-based crisis checklists, or cognitive aids, that can improve team performance. EMs are used in other safety-critical industries, and health care simulation studies have shown their efficacy, but use in clinical settings is nascent. A case study was conducted on the use of an EM during one intraoperative crisis, which entailed the assessment of the impact of the EM's use on teamwork and patient care and the identification of lessons for effectively using EMs during future clinical crises...
August 2018: Joint Commission Journal on Quality and Patient Safety
P Charco-Mora, R Urtubia, L Reviriego-Agudo
Airway management is an essential area in anaesthesia, and anaesthesiologists are considered the most expert professionals to manage airway tasks. However, complications related to inadequate airway management remain the most frequent cause of morbidity and mortality. Algorithmic strategy to solve difficulties fails, due to several factors related to its structure and clinical application. The Vortex Approach has emerged as a response to the limitations found in the algorithmic strategy of managing the difficult airway, by using a cognitive aid strategy to reduce cognitive load and fixation error...
August 2018: Revista Española de Anestesiología y Reanimación
M I Rudolph, H V Chitilian, P Y Ng, F P Timm, A V Agarwala, A B Doney, S K Ramachandran, T T Houle, M Eikermann
Inappropriate dosing of neostigmine for antagonism of neuromuscular blockade has been associated with postoperative pulmonary complications. We evaluated the effects of a quality improvement initiative tailored to optimise the use of neostigmine in antagonising neuromuscular blockade on postoperative pulmonary complications, costs and duration of hospital stay. The quality improvement initiative consisted of: a reduction in available neostigmine aliquot sizes; a cognitive aid; an educational component; and a financial incentive for the intra-operative documentation of train-of-four measurement before administration of neostigmine...
September 2018: Anaesthesia
Stephen J Gleich, Amy C S Pearson, Kevin C Lindeen, Ryan E Hofer, George D Gilkey, Luann F Borst, Dawit T Haile, David P Martin
BACKGROUND: The use of cognitive aids, such as emergency manuals (EMs), improves team performance on critical steps during crisis events. In our large academic anesthesia practice, we sought to broadly implement an EM and subsequently evaluate team member performance on critical steps. METHODS: We observed the phases of implementing an EM at a large academic anesthesia practice from 2013 to 2016, including the formation of the EM implementation team, identification of preferred EM characteristics, consideration of institution-specific factors, selection of the preferred EM, recognition of logistical barriers, and staff education...
June 28, 2018: Anesthesia and Analgesia
Lisa Umphrey, Morten Breindahl, Alexandra Brown, Ola Didrik Saugstad, Marta Thio, Daniele Trevisanuto, Charles Christoph Roehr, Mats Blennow
BACKGROUND: Neonatal resuscitation (NR) combines a set of life-saving interventions in order to stabilize compromised newborns at birth or when critically ill. Médecins Sans Frontières/Doctors Without Borders (MSF), as an international medical-humanitarian organization working particularly in low-resource settings (LRS), assisted over 250,000 births in obstetric and newborn care aid projects in 2016 and provides thousands of newborn resuscitations annually. The Helping Babies Breathe (HBB) program has been used as formal guidance for basic resuscitation since 2012...
2018: Neonatology
Roderick King, Jaber Hanhan, T Kyle Harrison, Alex Kou, Steven K Howard, Lindsay K Borg, Cynthia Shum, Ankeet D Udani, Edward R Mariano
BACKGROUND: Malignant hyperthermia is a rare but potentially fatal complication of anesthesia, and several different cognitive aids designed to facilitate a timely and accurate response to this crisis currently exist. Eye tracking technology can measure voluntary and involuntary eye movements, gaze fixation within an area of interest, and speed of visual response and has been used to a limited extent in anesthesiology. METHODS: With eye tracking technology, we compared the accessibility of five malignant hyperthermia cognitive aids by collecting gaze data from twelve volunteer participants...
August 2018: Korean Journal of Anesthesiology
Jared F Benge, Kara L Dinh, Erin Logue, Richard Phenis, Michelle N Dasse, Michael K Scullin
Smartphones have potential as cognitive aids for adults with cognitive impairments. However, little is known about how patients and their care partners utilise smartphones in their day-to-day lives. We collected self-reported smartphone utilisation data from patients referred for neuropsychological evaluations (N = 53), their care partners (N = 44), and an Amazon Mechanical Turk control sample (N = 204). Patient participants were less likely to own a smartphone than controls, with increasing age associated with less utilisation of smartphone features in all groups...
April 16, 2018: Neuropsychological Rehabilitation
Richard C Robert, Chirag M Patel
An effective office emergency preparedness plan for the oral and maxillofacial surgery office can be developed through the use of well-designed checklists, cognitive aids, and regularly scheduled in situ simulations with debriefings. In order to achieve this goal, the hierarchal culture of medicine and dentistry must be overcome, and an inclusive team concept embraced by all members of the staff. Technologic advancements in office automation now make it possible to create interactive cognitive aids. These enhance office emergency training and provide a means for more rapid retrieval of essential information and guidance during both simulations and a real crisis...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
Shehnaz Alidina, Sara N Goldhaber-Fiebert, Alexander A Hannenberg, David L Hepner, Sara J Singer, Bridget A Neville, James R Sachetta, Stuart R Lipsitz, William R Berry
BACKGROUND: Operating room (OR) crises are high-acuity events requiring rapid, coordinated management. Medical judgment and decision-making can be compromised in stressful situations, and clinicians may not experience a crisis for many years. A cognitive aid (e.g., checklist) for the most common types of crises in the OR may improve management during unexpected and rare events. While implementation strategies for innovations such as cognitive aids for routine use are becoming better understood, cognitive aids that are rarely used are not yet well understood...
March 26, 2018: Implementation Science: IS
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