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Moon SH, Jeong H, Choi MJ. Integrating mixed reality preparation into acute coronary syndrome simulation for nursing students: a single-group pretest-posttest study. BMC Nurs 2024; 23:468. [PMID: 38982463 PMCID: PMC11232335 DOI: 10.1186/s12912-024-02110-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/18/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Timely and effective intervention within the 'golden hour'-the critical first 90 min after the symptom onset-is crucial for initiating life-saving treatment and reducing mortality in acute coronary syndrome (ACS). This highlights the need for nursing students to be proficient in ACS care, emphasizing the importance of preparatory training. This study enhanced traditional simulation methods by integrating a mixed reality (MR) preparation step, offering a more immersive learning experience. We aimed to evaluate the effectiveness of integrating MR preparation into ACS simulation education, focusing on enhancements in knowledge, self-confidence in learning, and self-efficacy in learning. Additionally, we examined performance, practice immersion, and satisfaction to comprehensively evaluate the MR application. METHODS One-group pretest-posttest design was implemented in a convenience sample of thirty-nine senior nursing students from a university in South Korea in August 2022. We developed a simulation program integrating MR preparation into ACS simulation (IMRP-ACSS), which was validated through expert review for content validity. The students participated in the simulation program over six hours across two days, including a 40-minute individual session of MR-based simulation preparation using head-mounted displays (the HoloLens 2). Individual changes in knowledge, self-confidence in learning, and self-efficacy in learning evaluated by the survey were analyzed using paired t-tests. Additionally, group performance assessed using the checklist was analyzed. Immersion and satisfaction were measured with a tool and a 10-point Likert scale, respectively. RESULTS Individually, participants demonstrated significantly increased knowledge (t = 11.87, p < .001), self-confidence in learning (t = 7.17, p < .001), and self-efficacy in learning (t = 4.70, p < .001) post-education. Group performance yielded a mean score of 56.43/70 ± 7.45. Groups scored higher in electrocardiogram interpretation, patient safety, and heparin administration. Participants reported a practice immersion level of 37.82/50 ± 9.13 and expressed satisfaction with the program, achieving an average score of 8.85/10 ± 1.35. CONCLUSION Integrating MR preparation into ACS simulation enhanced nursing students' knowledge, self-confidence in learning, and self-efficacy in ACS care, providing a replicable and immersive learning experience. This method is an effective addition to nursing education, preparing students through comprehensive, technology-enhanced training.
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Affiliation(s)
- Sun-Hee Moon
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Hyeonjin Jeong
- Clinical Research Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Mi Jin Choi
- College of Nursing, Gyeongsang National University, Jinju, South Korea.
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Worlikar H, Coleman S, Kelly J, O'Connor S, Murray A, McVeigh T, Doran J, McCabe I, O'Keeffe D. Mixed Reality Platforms in Telehealth Delivery: Scoping Review. JMIR BIOMEDICAL ENGINEERING 2023; 8:e42709. [PMID: 38875694 PMCID: PMC11041465 DOI: 10.2196/42709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/03/2022] [Accepted: 11/16/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The distinctive features of the digital reality platforms, namely augmented reality (AR), virtual reality (VR), and mixed reality (MR) have extended to medical education, training, simulation, and patient care. Furthermore, this digital reality technology seamlessly merges with information and communication technology creating an enriched telehealth ecosystem. This review provides a composite overview of the prospects of telehealth delivered using the MR platform in clinical settings. OBJECTIVE This review identifies various clinical applications of high-fidelity digital display technology, namely AR, VR, and MR, delivered using telehealth capabilities. Next, the review focuses on the technical characteristics, hardware, and software technologies used in the composition of AR, VR, and MR in telehealth. METHODS We conducted a scoping review using the methodological framework and reporting design using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. Full-length articles in English were obtained from the Embase, PubMed, and Web of Science databases. The search protocol was based on the following keywords and Medical Subject Headings to obtain relevant results: "augmented reality," "virtual reality," "mixed-reality," "telemedicine," "telehealth," and "digital health." A predefined inclusion-exclusion criterion was developed in filtering the obtained results and the final selection of the articles, followed by data extraction and construction of the review. RESULTS We identified 4407 articles, of which 320 were eligible for full-text screening. A total of 134 full-text articles were included in the review. Telerehabilitation, telementoring, teleconsultation, telemonitoring, telepsychiatry, telesurgery, and telediagnosis were the segments of the telehealth division that explored the use of AR, VR, and MR platforms. Telerehabilitation using VR was the most commonly recurring segment in the included studies. AR and MR has been mainly used for telementoring and teleconsultation. The most important technical features of digital reality technology to emerge with telehealth were virtual environment, exergaming, 3D avatars, telepresence, anchoring annotations, and first-person viewpoint. Different arrangements of technology-3D modeling and viewing tools, communication and streaming platforms, file transfer and sharing platforms, sensors, high-fidelity displays, and controllers-formed the basis of most systems. CONCLUSIONS This review constitutes a recent overview of the evolving digital AR and VR in various clinical applications using the telehealth setup. This combination of telehealth with AR, VR, and MR allows for remote facilitation of clinical expertise and further development of home-based treatment. This review explores the rapidly growing suite of technologies available to users within the digital health sector and examines the opportunities and challenges they present.
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Affiliation(s)
- Hemendra Worlikar
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
| | - Sean Coleman
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
- Department of Medicine, University Hospital Galway, Galway, Ireland
| | - Jack Kelly
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
- Department of Medicine, University Hospital Galway, Galway, Ireland
| | - Sadhbh O'Connor
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
- Department of Medicine, University Hospital Galway, Galway, Ireland
| | - Aoife Murray
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
| | - Terri McVeigh
- Cancer Genetics Unit, The Royal Marsden National Health Service Foundation Trust, London, United Kingdom
| | - Jennifer Doran
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
| | - Ian McCabe
- Health Innovation Via Engineering Laboratory, Cúram Science Foundation Ireland Research Centre for Medical Devices, University of Galway, Galway, Ireland
| | - Derek O'Keeffe
- Department of Medicine, University Hospital Galway, Galway, Ireland
- School of Medicine, College of Medicine Nursing and Health Sciences, University of Galway, Galway, Ireland
- Lero, Science Foundation Ireland Centre for Software Research, University of Limerick, Limerick, Ireland
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Aranda-García S, Santos-Folgar M, Fernández-Méndez F, Barcala-Furelos R, Pardo Ríos M, Hernández Sánchez E, Varela-Varela L, San Román-Mata S, Rodríguez-Núñez A. "Dispatcher, Can You Help Me? A Woman Is Giving Birth". A Pilot Study of Remote Video Assistance with Smart Glasses. SENSORS (BASEL, SWITZERLAND) 2022; 23:s23010409. [PMID: 36617008 PMCID: PMC9824362 DOI: 10.3390/s23010409] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 05/20/2023]
Abstract
Smart glasses (SG) could be a breakthrough in emergency situations, so the aim of this work was to assess the potential benefits of teleassistance with smart glasses (SG) from a midwife to a lifeguard in a simulated, unplanned, out-of-hospital birth (OHB). Thirty-eight lifeguards were randomized into SG and control (CG) groups. All participants were required to act in a simulated imminent childbirth with a maternal−fetal simulator (PROMPT Flex, Laerdal, Norway). The CG acted autonomously, while the SG group was video-assisted by a midwife through SG (Vuzix Blade, New York, NY, USA). The video assistance was based on the OHB protocol, speaking and receiving images on the SG. The performance time, compliance with the protocol steps, and perceived performance with the SG were evaluated. The midwife’s video assistance with SG allowed 35% of the SG participants to perform the complete OHB protocol. No CG participant was able to perform it (p = 0.005). All OHB protocol variables were significantly better in the SG group than in the CG (p < 0.05). Telemedicine through video assistance with SG is feasible so that a lifeguard with no knowledge of childbirth care can act according to the recommendations in a simulated, unplanned, uncomplicated OHB. Communication with the midwife by speaking and sending images to the SG is perceived as an important benefit to the performance.
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Affiliation(s)
- Silvia Aranda-García
- GRAFAIS Research Group, Institut Nacional d’Educació Física de Catalunya (INEFC), Universitat de Barcelona, 08840 Barcelona, Spain
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Myriam Santos-Folgar
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, 36310 Pontevedra, Spain
- School of Nursing from Pontevedra, Universidade de Vigo, 36004 Pontevedra, Spain
- Department of Obstetrics, Complexo Hospitalario Universitario de Pontevedra, SERGAS, 36002 Pontevedra, Spain
- Correspondence: (M.S.-F.); (S.S.R.-M.); Tel.: +00-(34)-886-211-900 (M.S.-F.); +00-(34)-630-120-241 (S.S.R.-M.)
| | - Felipe Fernández-Méndez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, 36310 Pontevedra, Spain
- School of Nursing from Pontevedra, Universidade de Vigo, 36004 Pontevedra, Spain
| | - Roberto Barcala-Furelos
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- REMOSS Research Group, Faculty of Education and Sport Sciences, Universidade de Vigo, 36310 Pontevedra, Spain
| | - Manuel Pardo Ríos
- Faculty of Nursing, Catholic University of Murcia (UCAM), 061 Emergency Services (112) of Murcia, 30107 Murcia, Spain
| | - Encarna Hernández Sánchez
- Faculty of Nursing, Catholic University of Murcia (UCAM), 061 Emergency Services (112) of Murcia, 30107 Murcia, Spain
| | - Lucía Varela-Varela
- Department of Obstetrics, Complexo Hospitalario Universitario de Pontevedra, SERGAS, 36002 Pontevedra, Spain
| | - Silvia San Román-Mata
- Faculty of Health Sciences of Melilla, University of Granada, 52005 Melilla, Spain
- Correspondence: (M.S.-F.); (S.S.R.-M.); Tel.: +00-(34)-886-211-900 (M.S.-F.); +00-(34)-630-120-241 (S.S.R.-M.)
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, Psychiatry, Radiology, Public Health, Nursing and Medicine Department, Faculty of Nursing, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain
- Pediatric Critical, Intermediate and Palliative Care Section, University Clinical Hospital of Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), RD21/0012/0025, Instituto de Salud Carlos III, 28220 Madrid, Spain
- SICRUS Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
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Davidson TJ, Sanderson PM. A review of the effects of head-worn displays on teamwork for emergency response. ERGONOMICS 2022; 65:188-218. [PMID: 34445922 DOI: 10.1080/00140139.2021.1968041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
Head-Worn Displays (HWD) can potentially support the mobile work of emergency responders, but it remains unclear whether teamwork is affected when emergency responders use HWDs. We reviewed studies that examined HWDs in emergency response contexts to evaluate the impact of HWDs on team performance and on team processes of situation awareness, communication, and coordination. Sixteen studies were identified through manual and systematic literature searches. HWDs appeared to improve the quality of team performance but they increased time to perform under some conditions; effects on team processes were mixed. We identify five challenges to explain the mixed results. We discuss four theoretical perspectives that might address the challenges and guide research needs-joint cognitive systems, distributed cognition, common ground, and dynamical systems. Researchers and designers should use process-based measures and apply greater theoretical guidance to uncover mechanisms by which HWDs shape team processes, and to understand the impact on team performance. Practitioner Summary: This review examines the effects of head-worn displays on teamwork performance and team processes for emergency response. Results are mixed, but study diversity challenges the search for underlying mechanisms. Guidance from perspectives such as joint cognitive systems, distributed cognition, common ground, and dynamical systems may advance knowledge in the area. Abbreviations: HWD: head-worn display; RC: remote collaboration; DD: data display; ARC: augmented remote collaboration; ACC: augmented collocated collaboration; SA: situation awareness; TSA: team situation awareness; CPR: cardiopulmonary resuscitation; SAGAT: situation awareness global assessment technique; SART: situation awareness rating technique.
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Affiliation(s)
- Thomas J Davidson
- School of Psychology, The University of Queensland, Brisbane, Australia
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Integration of Extended Reality and a High-Fidelity Simulator in Team-Based Simulations for Emergency Scenarios. ELECTRONICS 2021. [DOI: 10.3390/electronics10172170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Wearable devices such as smart glasses are considered promising assistive tools for information exchange in healthcare settings. We aimed to evaluate the usability and feasibility of smart glasses for team-based simulations constructed using a high-fidelity simulator. Two scenarios of patients with arrhythmia were developed to establish a procedure for interprofessional interactions via smart glasses using 15-h simulation training. Three to four participants formed a team and played the roles of remote supporter or bed-side trainee with smart glasses. Usability, attitudes towards the interprofessional health care team and learning satisfaction were assessed. Using a 5-point Likert scale, from 1 (strongly disagree) to 5 (strongly agree), 31 participants reported that the smart glasses were easy to use (3.61 ± 0.95), that they felt confident during use (3.90 ± 0.87), and that that responded positively to long-term use (3.26 ± 0.89) and low levels of physical discomfort (1.96 ± 1.06). The learning satisfaction was high (4.65 ± 0.55), and most (84%) participants found the experience favorable. Key challenges included an unstable internet connection, poor resolution and display, and physical discomfort while using the smart glasses with accessories. We determined the feasibility and acceptability of smart glasses for interprofessional interactions within a team-based simulation. Participants responded favorably toward a smart glass-based simulation learning environment that would be applicable in clinical settings.
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Kim KJ, Choi MJ, Kim KJ. Effects of Nursing Simulation Using Mixed Reality: A Scoping Review. Healthcare (Basel) 2021; 9:947. [PMID: 34442084 PMCID: PMC8393957 DOI: 10.3390/healthcare9080947] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 01/04/2023] Open
Abstract
Mixed reality (MR) has recently been suggested as a new educational tool for nursing simulation. However, few studies have assessed the use and evaluation of MR nursing simulations. Therefore, this review identified studies of MR nursing simulations through a scoping review using the framework proposed by Arksey and O'Malley. The studies reviewed were found through DBpia, RISS, PubMed, CINAHL, and Google Scholar. Each study was analyzed, and data were abstracted into publication characteristics, simulation program details, device use, and simulation evaluation. A total of 10 studies were reviewed. Senses that were mainly used in MR nursing simulation included audition and haptics via motion, in addition to visual information. Simulations were evaluated using various outcome variables. Knowledge was most commonly evaluated, followed by clinical performance and satisfaction. This study is significant as it analyzed trends in research on MR nursing simulations in Korea and other countries and suggested directions for the use of MR technology in nursing simulations based on the findings. Additional studies are required to develop scenarios for the effective use of MR in nursing education and to evaluate the effects of MR nursing simulations.
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Affiliation(s)
- Kyeng-Jin Kim
- Department of Nursing, Kyungil University, Gyeongsan 38428, Korea; (K.-J.K.); (M.-J.C.)
| | - Moon-Ji Choi
- Department of Nursing, Kyungil University, Gyeongsan 38428, Korea; (K.-J.K.); (M.-J.C.)
| | - Kyu-Jin Kim
- Daegu Center for Infectious Diseases Control and Prevention, Daegu 41940, Korea
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Kuyt K, Park SH, Chang TP, Jung T, MacKinnon R. The use of virtual reality and augmented reality to enhance cardio-pulmonary resuscitation: a scoping review. Adv Simul (Lond) 2021; 6:11. [PMID: 33845911 PMCID: PMC8040758 DOI: 10.1186/s41077-021-00158-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Virtual reality (VR) and augmented reality (AR) have been proposed as novel methods to enhance cardio-pulmonary resuscitation (CPR) performance and increase engagement with CPR training. A scoping review was conducted to map the global evolution of these new approaches to CPR training, to assess their efficacy and determine future directions to meet gaps in current knowledge. METHODS A standardised five-stage scoping methodology was used to (1) identify the research question, (2) identify relevant studies, (3) select the studies, (4) chart the data and (5) summarise the findings. The Kirkpatrick model levels of evidence were used to chart and assess the efficacy of each intervention reported. A multi-pronged search term strategy was used to search the Web of Science, PubMed, CINAHL and EMBASE databases up to June 2020. RESULTS A total of 42 articles were included in this review. The first relevant paper identified was published in 2009 and based on VR, from 2014 onwards there was a large increase in the volume of work being published regarding VR and AR uses in CPR training. This review reports Kirkpatrick level one to three evidence for the use of VR/AR-CPR. Inconsistencies in the specific language, keywords used and methodologies are highlighted. CONCLUSION VR and AR technologies have shown great potential in the area of CPR, and there is continuing evidence of new novel applications and concepts. As VR/AR research into CPR reaches an inflection point, it is key to bring collaboration and consistency to the wider research community, to enable the growth of the area and ease of access to the wider medical community.
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Affiliation(s)
- Katherine Kuyt
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Sang-Hee Park
- Korea Institute of Civil Engineering and Building Technology, Seoul, South Korea
| | - Todd P Chang
- Children's Hospital Los Angeles, Los Angeles, USA
| | - Timothy Jung
- Manchester Metropolitan University, Manchester, UK
| | - Ralph MacKinnon
- Manchester University NHS Foundation Trust, Manchester, UK.
- Manchester Metropolitan University, Manchester, UK.
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Siebert JN, Lacroix L, Cantais A, Manzano S, Ehrler F. The Impact of a Tablet App on Adherence to American Heart Association Guidelines During Simulated Pediatric Cardiopulmonary Resuscitation: Randomized Controlled Trial. J Med Internet Res 2020; 22:e17792. [PMID: 32292179 PMCID: PMC7287744 DOI: 10.2196/17792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/22/2020] [Accepted: 03/23/2020] [Indexed: 12/13/2022] Open
Abstract
Background Evidence-based best practices are the cornerstone to guide optimal cardiopulmonary arrest resuscitation care. Adherence to the American Heart Association (AHA) guidelines for cardiopulmonary resuscitation (CPR) optimizes the management of critically ill patients and increases their chances of survival after cardiac arrest. Despite advances in resuscitation science and survival improvement over the last decades, only approximately 38% of children survive to hospital discharge after in-hospital cardiac arrest and only 6%-20% after out-of-hospital cardiac arrest. Objective We investigated whether a mobile app developed as a guide to support and drive CPR providers in real time through interactive pediatric advanced life support (PALS) algorithms would increase adherence to AHA guidelines and reduce the time to initiation of critical life-saving maneuvers compared to the use of PALS pocket reference cards. Methods This study was a randomized controlled trial conducted during a simulation-based pediatric cardiac arrest scenario caused by pulseless ventricular tachycardia (pVT). A total of 26 pediatric residents were randomized into two groups. The primary outcome was the elapsed time in seconds in each allocation group from the onset of pVT to the first defibrillation attempt. Secondary outcomes were time elapsed to (1) initiation of chest compression, (2) subsequent defibrillation attempts, and (3) administration of drugs, including the time intervals between defibrillation attempts and drug doses, shock doses, and the number of shocks. All outcomes were assessed for deviation from AHA guidelines. Results Mean time to the first defibrillation attempt (121.4 sec, 95% CI 105.3-137.5) was significantly reduced among residents using the app compared to those using PALS pocket cards (211.5 sec, 95% CI 162.5-260.6, P<.001). With the app, 11 out of 13 (85%) residents initiated chest compressions within 60 seconds from the onset of pVT and 12 out of 13 (92%) successfully defibrillated within 180 seconds. Time to all other defibrillation attempts was reduced with the app. Adherence to the 2018 AHA pVT algorithm improved by approximately 70% (P=.001) when using the app following all CPR sequences of action in a stepwise fashion until return of spontaneous circulation. The pVT rhythm was recognized correctly in 51 out of 52 (98%) opportunities among residents using the app compared to only 19 out of 52 (37%) among those using PALS cards (P<.001). Time to epinephrine injection was similar. Among a total of 78 opportunities, incorrect shock or drug doses occurred in 14% (11/78) of cases among those using the cards. These errors were reduced to 1% (1/78, P=.005) when using the app. Conclusions Use of the mobile app was associated with a shorter time to first and subsequent defibrillation attempts, fewer medication and defibrillation dose errors, and improved adherence to AHA recommendations compared with the use of PALS pocket cards.
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Affiliation(s)
- Johan N Siebert
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, Geneva University, Geneva, Switzerland
| | - Laurence Lacroix
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Aymeric Cantais
- Pediatric Emergency Department, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Sergio Manzano
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Frederic Ehrler
- Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
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Balian S, McGovern SK, Abella BS, Blewer AL, Leary M. Feasibility of an augmented reality cardiopulmonary resuscitation training system for health care providers. Heliyon 2019; 5:e02205. [PMID: 31406943 PMCID: PMC6684477 DOI: 10.1016/j.heliyon.2019.e02205] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/08/2019] [Accepted: 07/30/2019] [Indexed: 10/31/2022] Open
Abstract
Aim of the study Augmented reality (AR) has the potential to offer a novel approach to CPR training that supplements conventional training methods with gamification and a more interactive learning experience. This is done through computer-generated imagery superimposed on users' view of the real environment to simulate interactive training scenarios. We sought to test the feasibility of an AR CPR training system (CPReality) for health care providers (HCPs). Methods In this feasibility trial, a CPR training manikin was integrated with a commercial AR device (Microsoft HoloLens) to provide participants with real-time audio-visual feedback via a holographic overlay of blood flow to vital organs dependent on CC quality. In this system, higher quality CC visually improved virtual blood circulation. HCPs performed a 2-minute cycle of hands-only CPR using only the AR system, and CC parameters were recorded. Descriptive data on participants' demographics, CC quality, and satisfaction with the training environment were reported using quantitative and qualitative analysis. Results Between 10/2018-11/2018, we enrolled a convenience sample of 51 HCPs. The median age of participants was 31 years (IQR 27-41), 71% (36/51) were female, and 67% (34/51) were registered nurses. CC rates (mean 126 ± 12.9 cpm), depths (median 53 mm, IQR 46-58), and percent with complete recoil (median 80%, IQR 12-100) were consistent with guideline recommendations for good quality CPR. Participants were predominantly satisfied with the system, with 82% perceiving the experience as realistic, 98% recognizing the visualizations as helpful for training, and 94% willing to use the application in future CPR training. Conclusions As AR is increasingly applied in the healthcare setting, integration in CPR training offers a novel and promising educational approach. In this convenience sample of trained HCPs, high quality CC delivery was feasible using the AR CPR training system which was received favorably by most participants.
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Affiliation(s)
- Steve Balian
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shaun K McGovern
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin S Abella
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Audrey L Blewer
- Department of Family Medicine and Community Health, Duke University, Durham, NC, USA
| | - Marion Leary
- Center for Resuscitation Science and Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA.,University of Pennsylvania, School of Nursing, Philadelphia, PA, USA
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Lyons PG, Edelson DP, Churpek MM. Rapid response systems. Resuscitation 2018; 128:191-197. [PMID: 29777740 DOI: 10.1016/j.resuscitation.2018.05.013] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/20/2018] [Accepted: 05/09/2018] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES Articles written in English and published in PubMed. RESULTS Rapid response systems are heterogeneous, with important differences among afferent and efferent arms. Clinically meaningful outcomes may include unexpected mortality, in-hospital cardiac arrest, length of stay, cost, and processes of care at end of life. Both positive and negative interventional studies have been published, although the two largest randomized trials involving rapid response systems - the Medical Early Response and Intervention Trial (MERIT) and the Effect of a Pediatric Early Warning System on All-Cause Mortality in Hospitalized Pediatric Patients (EPOCH) trial - did not find a mortality benefit with these systems, albeit with important limitations. Advances in monitoring technologies, risk assessment strategies, and behavioral ergonomics may offer opportunities for improvement. CONCLUSIONS Rapid responses may improve some meaningful outcomes, although these findings remain controversial. These systems may also improve care for patients at the end of life. Rapid response systems are expected to continue evolving with novel developments in monitoring technologies, risk prediction informatics, and work in human factors.
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Affiliation(s)
- Patrick G Lyons
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Dana P Edelson
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Matthew M Churpek
- Department of Medicine, University of Chicago, Chicago, IL, United States.
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