Effect of a Mobile App on Prehospital Medication Errors During Simulated Pediatric Resuscitation: A Randomized Clinical Trial
type: Article
item type: journalArticle
is part of: JAMA Netw Open
authors: Person
  surname: Siebert
  given name: J. N.
authors: Person
  surname: Bloudeau
  given name: L.
authors: Person
  surname: Combescure
  given name: C.
authors: Person
  surname: Haddad
  given name: K.
authors: Person
  surname: Hugon
  given name: F.
authors: Person
  surname: Suppan
  given name: L.
authors: Person
  surname: Rodieux
  given name: F.
authors: Person
  surname: Lovis
  given name: C.
authors: Person
  surname: Gervaix
  given name: A.
authors: Person
  surname: Ehrler
  given name: F.
authors: Person
  surname: Manzano
  given name: S.
authors: Person
  surname: Pediatric Accurate Medication in Emergency Situations Prehospital
  given name: Group
subject: *Mobile Applications
subject: Adult
subject: Cardiopulmonary Resuscitation/*education/*standards
subject: Emergency Medical Services/*standards/statistics & numerical data
subject: Emergency Medical Technicians/*education
subject: Female
subject: Humans
subject: Male
subject: Medication Errors/*prevention & control/statistics & numerical data
subject: Middle Aged
subject: Out-of-Hospital Cardiac Arrest/*therapy
subject: Practice Guidelines as Topic
subject: Simulation Training/methods
subject: Switzerland
subject: Young Adult
abstract: IMPORTANCE: Medication errors are a leading cause of injury and avoidable harm, affecting millions of people worldwide each year. Children are particularly susceptible to medication errors, but innovative interventions for the prevention of these errors in prehospital emergency care are lacking. OBJECTIVE: To assess the efficacy of an evidence-based mobile app in reducing the occurrence of medication errors compared with conventional preparation methods during simulated pediatric out-of-hospital cardiac arrest scenarios. DESIGN, SETTING, AND PARTICIPANTS: This nationwide, open-label, multicenter, randomized clinical trial was conducted at 14 emergency medical services centers in Switzerland from September 3, 2019, to January 21, 2020. The participants were 150 advanced paramedics with drug preparation autonomy. Each participant was exposed to a 20-minute, standardized, fully video-recorded, realistic pediatric out-of-hospital cardiac arrest cardiopulmonary resuscitation scenario concerning an 18-month-old child. Participants were tested on sequential preparations of 4 intravenous emergency drugs of varying degrees of preparation difficulty (epinephrine, midazolam, 10% dextrose, and sodium bicarbonate). INTERVENTION: Participants were randomized (1:1 ratio) to the support of an app designed to assist with pediatric drug preparation (intervention; n = 74) or to follow conventional drug preparation methods without assistance (control; n = 76). MAIN OUTCOMES AND MEASURES: The primary outcome was the rate of medication errors, defined as a failure in drug preparation according to predefined, expert consensus-based criteria. Logistic regression models with mixed effects were used to assess the effect of the app on binary outcomes. Secondary outcomes included times to drug preparation and delivery, assessed with linear regression models with mixed effects. RESULTS: In total, 150 advanced paramedics (mean [SD] age, 35.6 [7.2] years; 101 men [67.3%]; mean [SD] time since par…
date: 2021-08-31
pages: e2123007
coverage: 34459905

JAMA Netw Open
type: Journal
volume: 4
number: 8
identifier: DOI 10.1001/jamanetworkopen.2021.23007
identifier: ISSN 2574-3805 (Electronic) 2574-3805 (Linking)