A mobile device app to reduce prehospital medication errors and time to drug preparation and delivery by emergency medical services during simulated pediatric cardiopulmonary resuscitation: study protocol of a multicenter, prospective, randomized controlled trial.


Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
20 Nov 2019
Historique:
received: 30 04 2019
accepted: 13 09 2019
entrez: 22 11 2019
pubmed: 22 11 2019
medline: 6 5 2020
Statut: epublish

Résumé

Emergency drug preparation and administration in children is both complex and time-consuming and places this population at a higher risk than adults for medication errors. Moreover, survival and a favorable neurological outcome from cardiopulmonary resuscitation are inversely correlated to drug preparation time. We developed a mobile device application (the pediatric Accurate Medication IN Emergency Situations (PedAMINES) app) as a step-by-step guide for the preparation to delivery of drugs requiring intravenous injection. In a previous multicenter randomized trial, we reported the ability of this app to significantly reduce in-hospital continuous infusion medication error rates and drug preparation time compared to conventional preparation methods during simulation-based pediatric resuscitations. This trial aims to evaluate the effectiveness of this app during pediatric out-of-hospital cardiopulmonary resuscitation. We will conduct a multicenter, prospective, randomized controlled trial to compare the PedAMINES app with conventional calculation methods for the preparation of direct intravenously administered emergency medications during standardized, simulation-based, pediatric out-of-hospital cardiac arrest scenarios using a high-fidelity manikin. One hundred and twenty paramedics will be randomized (1:1) in several emergency medical services located in different regions of Switzerland. Each paramedic will be asked to prepare, sequentially, four intravenously administered emergency medications using either the app or conventional methods. The primary endpoint is the medication error rates. Enrollment will start in mid-2019 and data analysis in late 2019. We anticipate that the intervention will be completed in early 2020 and study results will be submitted in late 2020 for publication (expected in early 2021). This clinical trial will assess the impact of an evidence-based mobile device app to reduce the rate of medication errors, time to drug preparation and time to drug delivery during prehospital pediatric resuscitation. As research in this area is scarce, the results generated from this study will be of great importance and may be sufficient to change and improve prehospital pediatric emergency care practice. ClinicalTrials.gov, ID: NCT03921346. Registered on 18 April 2019.

Sections du résumé

BACKGROUND BACKGROUND
Emergency drug preparation and administration in children is both complex and time-consuming and places this population at a higher risk than adults for medication errors. Moreover, survival and a favorable neurological outcome from cardiopulmonary resuscitation are inversely correlated to drug preparation time. We developed a mobile device application (the pediatric Accurate Medication IN Emergency Situations (PedAMINES) app) as a step-by-step guide for the preparation to delivery of drugs requiring intravenous injection. In a previous multicenter randomized trial, we reported the ability of this app to significantly reduce in-hospital continuous infusion medication error rates and drug preparation time compared to conventional preparation methods during simulation-based pediatric resuscitations. This trial aims to evaluate the effectiveness of this app during pediatric out-of-hospital cardiopulmonary resuscitation.
METHODS/DESIGN METHODS
We will conduct a multicenter, prospective, randomized controlled trial to compare the PedAMINES app with conventional calculation methods for the preparation of direct intravenously administered emergency medications during standardized, simulation-based, pediatric out-of-hospital cardiac arrest scenarios using a high-fidelity manikin. One hundred and twenty paramedics will be randomized (1:1) in several emergency medical services located in different regions of Switzerland. Each paramedic will be asked to prepare, sequentially, four intravenously administered emergency medications using either the app or conventional methods. The primary endpoint is the medication error rates. Enrollment will start in mid-2019 and data analysis in late 2019. We anticipate that the intervention will be completed in early 2020 and study results will be submitted in late 2020 for publication (expected in early 2021).
DISCUSSION CONCLUSIONS
This clinical trial will assess the impact of an evidence-based mobile device app to reduce the rate of medication errors, time to drug preparation and time to drug delivery during prehospital pediatric resuscitation. As research in this area is scarce, the results generated from this study will be of great importance and may be sufficient to change and improve prehospital pediatric emergency care practice.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov, ID: NCT03921346. Registered on 18 April 2019.

Identifiants

pubmed: 31747951
doi: 10.1186/s13063-019-3726-4
pii: 10.1186/s13063-019-3726-4
pmc: PMC6868759
doi:

Banques de données

ClinicalTrials.gov
['NCT03921346']

Types de publication

Clinical Trial Protocol Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

634

Subventions

Organisme : Swiss National Science Foundation
ID : 32003B_182374
Pays : Switzerland

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Auteurs

Johan N Siebert (JN)

Children's Hospital, Department of Pediatric Emergency Medicine, Geneva University Hospitals, 47 Avenue de la Roseraie, 1211, Geneva 14, Switzerland. Johan.Siebert@hcuge.ch.

Laurie Bloudeau (L)

A.C.E. Geneva Ambulances SA, 2 Route de Jussy, 1225, Geneva, Switzerland.

Frédéric Ehrler (F)

Division of Medical Information Sciences, Department of Radiology and Medical Informatics, Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.

Christophe Combescure (C)

Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva and Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.

Kevin Haddad (K)

Children's Hospital, Department of Pediatric Emergency Medicine, Geneva University Hospitals, 47 Avenue de la Roseraie, 1211, Geneva 14, Switzerland.

Florence Hugon (F)

Children's Hospital, Department of Pediatric Emergency Medicine, Geneva University Hospitals, 47 Avenue de la Roseraie, 1211, Geneva 14, Switzerland.

Laurent Suppan (L)

Department of Emergency Medicine, Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.

Frédérique Rodieux (F)

Service of Clinical Pharmacology and Toxicology, Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.

Christian Lovis (C)

Division of Medical Information Sciences, Department of Radiology and Medical Informatics, Geneva University Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland.
Geneva University Faculty of Medicine, 1 Rue Michel Servet, 1205, Geneva, Switzerland.

Alain Gervaix (A)

Children's Hospital, Department of Pediatric Emergency Medicine, Geneva University Hospitals, 47 Avenue de la Roseraie, 1211, Geneva 14, Switzerland.
Geneva University Faculty of Medicine, 1 Rue Michel Servet, 1205, Geneva, Switzerland.

Sergio Manzano (S)

Children's Hospital, Department of Pediatric Emergency Medicine, Geneva University Hospitals, 47 Avenue de la Roseraie, 1211, Geneva 14, Switzerland.
Geneva University Faculty of Medicine, 1 Rue Michel Servet, 1205, Geneva, Switzerland.

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