Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2011
Medication related computerized decision support system (CDSS): make it a clinicians' partner!
Medication related Computerized Decision Support System (CDSS) are known to have a positive impact on Adverse Drug Events (ADE) prevention but they face acceptance problems due to over alerting and usability issues. We present here a Human factors approach to the design of these Clinical Decision Support (CDS) functions and to their integration into different Electronic Health Record (EHR) / Computerized Physicians Order Entry (CPOE) systems, so that the resulting CDSS corresponds to the users needs and fits clinical workflows and cognitive processes. We used ethnographic observations completed with semi-structured interviews to analyse existing work situations and work processes. ⋯ This makes the system able to catch the context of the monitoring of the drugs through their corresponding lab tests and lab results (e.g. kalemia for potassium) and also part of the context of the clinical status of the patient (actual lab values, but also diseases and other pathologies that are identified as potential causes of the ADE e.g. renal insufficiency and potassium). We show that making the system able to catch the monitoring and clinical contexts opens interesting opportunities for the design of the CDS information content and display mode. Implementing this model would allow the CDSS to take into account the actions already engaged by the healthcare team and to adapt the information delivered to the monitoring and clinical context, thus making the CDSS a partner to the clinicians, nurses and pharmacists.
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Stud Health Technol Inform · Jan 2011
Combined intubation training (simulated and human) for 4th year medical students: the Center for Advanced Technology and Telemedicine airway training program.
The video laryngoscope is a useful tool in intubation training as it allows both the trainer and the student to share the same view of the airway during the intubation process. In this study, the Center for Advanced Technology and Telemedicine's airway training program employed videolaryngoscopy (VL) in teaching both simulated (manikin) and human intubation. ⋯ With human intubation training, there was statistically significant improvement in airway views using VL and a 97.5% intubation success rate. The enhanced view of the videolaryngoscope in airway intubation facilitates the learning process in performing both simulated and human intubation, making it a powerful tool in intubation training.
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Stud Health Technol Inform · Jan 2011
Field use of the STORZ C-MAC video laryngoscope in intubation training with the Nebraska National Air Guard.
Previous studies have shown that the videolaryngoscope is an excellent intubation training tool as it allows the student and trainer to share the same anatomical view of the airway. Use of this training tool is limited; however, as many times intubation training must take place outside the hospital environment (as in the training of military health care providers). ⋯ This study examined the use of the Storz CMAC, a compact video laryngoscope system, for intubation training in a simulated field hospital setting with the Nebraska National Air Guard. The study showed that the C-MAC was well-received by the trainees and would be useful in a deployment or hospital setting.
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Stud Health Technol Inform · Jan 2011
The tool positioning tutor: a target-pose tracking and display system for learning correct placement of a medical device.
Safe and successful performance of medical procedures often requires the correct manual positioning of a tool. For example, during endotracheal intubation a laryngoscope is used to open a passage in the airway through which a breathing tube is inserted. During training it can be challenging for an experienced practitioner to effectively communicate to a novice the correct placement and orientation of a tool. ⋯ The system displays to the learner the fixed, target pose and a real-time display of the current, "live" laryngoscope position. Positional error metrics are displayed as color-coded visual cues to guide the user toward successful targeting of the reference position. This technique provides quantitative assessment of the degree to which a learner has matched a specified "expert" position with a tool, and is potentially applicable to a wide variety of tools and procedures.
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Stud Health Technol Inform · Jan 2011
The combined use of Skype and the STORZ CMAC video laryngoscope in field intubation training with the Nebraska National Air Guard.
This study examined the feasibility of using Skype technology in basic manikin intubation instruction of Nebraska National Air Guard personnel at a Casualty Training Exercise. Results show that the Skype monitor provided clear sound and visualization of the airway view to the trainees and the combination of VoIP technology and videolaryngoscopy for intubation training was highly valued by study participants.