Workload effects on response time to life-threatening arrhythmias

13 Pages·2015·0.44 MB·English

Workload effects on response time
to life-threatening arrhythmias
Noa Segall
Duke University Medical Center, Durham, NC
Melanie C. Wright
Trinity Health, Boise, ID
Introduction
Introduction
Methods
Study design
• Randomized trial
• Independent variable
– Patient load: 16, 24, 32, 40, and 48 patients
• Dependent variables
– Response time to a simulated ventricular fibrillation
– Participants requiring 20 sec or longer to respond
– Task performance
– Rhythm interpretation
• Participants
– 15 remote telemetry technicians
– 27 nurses from cardiac units
Methods
Simulation design
Methods
Simulation design
Patient Event Required Tasks Weight
Call HUC 5
Tachycardia (a 30-bpm
Make phone call within 1 minute 4
increase from baseline)
Ask to speak to the patient’s nurse 3
State correct problem 4
Bradycardia (< 45 bpm)
Print rhythm strips 1
Converting to a different Send 1 strip to the patient’s nurse 1
rhythm, e.g., Afib Document the patient’s number, the current time, 1
the nurse’s name, and the rhythm
Methods
Simulation design
Results
Response time
25
Individual Response
Times
Mean Response Time
20
)
s
d
n
o
c
e15
s
(
e
m
Ti
e
s
n
o10
p
s
e
R
5
0
16 24 32 40 48
Number of Patients Monitored
Results
Task performance
90%
80%
70%
)
%
(60%
e
r
o
c
S
e 50%
c
n
a
m
40%
r
o
rf
e
P
k 30%
s
a
T
20%
10%
0%
16 24 32 40 48
Number of Patients Monitored
Results
Survey
Strongly Agree/
Disagree/ Neutral Strongly
Disagree Agree
The experiment was long enough to accurately assess my
1 0 39
workload
The lethal rhythm (VF) was realistic (similar to a real VF) 1 0 41
The waveforms were clear enough to interpret 3 5 34
The pace of patient events was realistic (technician responses
0 1 14
only)
My documentation tasks were realistic (technician responses
0 2 13
only)
The phone conversations were realistic (technician responses
1 0 14
only)
Overall, the experiment was realistic (similar to real
1 2 12
cardiac monitoring) (technician responses only)