Background
Objective
Methods
Trial design
Participants and recruitment
Random allocation
Intervention
Usual care
Outcomes
Statistical analyses
Results
Sample description
Number | Percentage | ||
---|---|---|---|
Gender | Female | 45 | 60 |
Male | 30 | 40 | |
Discipline | Medical | 38 | 51 |
Nursing | 37 | 49 | |
Medical (n = 35)1 | Junior Medical Officer | 20 | 57 |
Resident Medical Officer | 1 | 3 | |
Registrar | 7 | 20 | |
GP/GP VMO | 4 | 11 | |
Career Medical Officer | 1 | 3 | |
Staff specialist/VMO | 2 | 6 | |
Nursing (n = 35)2 | Registered nurse | 23 | 66 |
Nursing manager | 3 | 9 | |
Clinical nurse specialist/educator | 8 | 23 | |
Nurse practitioner | 1 | 3 | |
Hospital type3 | Base and tertiary | 44 | 61 |
Rural | 22 | 31 | |
Rural and base | 1 | 1 | |
Tertiary | 3 | 4 | |
None | 2 | 3 |
Analyses of handbook use
Scenario | Handbook | Number of errors | Total possible errors | Mean error rate (%) | SE of mean error rate | Number of teams | Median error rate (%) | Error rate range (%) |
---|---|---|---|---|---|---|---|---|
Neonatal | Not used | 56 | 150 | 37.33 | 4.98 | 10 | 40.0 | 13.3–60.0 |
Used | 24 | 165 | 14.54 | 3.21 | 11 | 13.3 | 0–33.3 | |
Total | 80 | 315 | 25.39 | 3.81 | 21 | 20.0 | 0–60.0 | |
Seizures | Not used | 55 | 165 | 33.33 | 4.11 | 11 | 40.0 | 6.7–53.3 |
Used | 18 | 150 | 12.00 | 2.39 | 10 | 13.3 | 0–26.7 | |
Total | 73 | 315 | 23.17 | 3.36 | 21 | 20.0 | 0–53.3 | |
Tricyclic | Not used | 66 | 150 | 44.00 | 7.77 | 10 | 50.0 | 6.7–73.3 |
Used | 33 | 165 | 20.00 | 4.21 | 11 | 26.7 | 0–40.0 | |
Total | 99 | 315 | 31.42 | 4.97 | 21 | 26.7 | 0–73.3 | |
VT | Not used | 62 | 150 | 41.33 | 3.82 | 10 | 40.0 | 13.3–60.0 |
Used | 46 | 165 | 27.87 | 2.95 | 11 | 33.3 | 13.3–40.0 | |
Total | 108 | 315 | 34.28 | 2.77 | 21 | 40.0 | 13.3–60.0 | |
Total | Not used | 239 | 615 | 38.86 | 2.65 | 41 | 40.0 | 6.7–73.3 |
Used | 121 | 645 | 18.75 | 1.84 | 43 | 20.0 | 0–40.0 | |
Total | 360 | 1260 | 28.57 | 1.93 | 84 | 26.7 | 0–73.3 |
Scenario | Number | Handbook | Error rate proportion | SE | 95% CI | Significant pairwise contrasts | p value | ||
---|---|---|---|---|---|---|---|---|---|
Main | 41 | Not used | 0.389 | 0.024 | 0.342–0.439 | ||||
43 | Used | 0.179 | 0.019 | 0.144–0.220 | 0.210 | <0.001 | |||
Main | Neonatal | 21 | 0.242 | 0.031 | 0.183–0.312 | N-VT | 0.101 | 0.014 | |
Seizures | 21 | 0.207 | 0.025 | 0.159–0.265 | VT-Seiz | 0.136 | <0.001 | ||
VT | 21 | 0.343 | 0.024 | 0.294–0.395 | |||||
Tricyclic | 21 | 0.307 | 0.045 | 0.222–0.407 | |||||
Interaction | Neonatal | 10 | Not used | 0.373 | 0.048 | 0.279–0.478 | |||
Seizures | 11 | Not used | 0.333 | 0.038 | 0.260–0.416 | ||||
VT | 10 | Not used | 0.413 | 0.036 | 0.340–0.490 | ||||
Tricyclic | 10 | Not used | 0.440 | 0.067 | 0.308–0.581 | ||||
Neonatal | 11 | Used | 0.145 | 0.033 | 0.088–0.230 | Used | 0.228 | 0.001 | |
Seizures | 10 | Used | 0.120 | 0.027 | 0.074–0.189 | Versus not used | 0.213 | <0.001 | |
VT | 11 | Used | 0.279 | 0.031 | 0.218–0.349 | Not | 0.135 | 0.011 | |
Tricyclic | 11 | Used | 0.200 | 0.051 | 0.113–0.328 | Used | 0.240 | 0.010 |
Process measures
Number | Percentage | Number | Percentage | Number | Percentage | Number | Percentage | Number | Percentage | |
---|---|---|---|---|---|---|---|---|---|---|
Strongly disagree | Disagree | Neutral | Agree | Strongly agree | ||||||
Sessions | ||||||||||
The sessions were realistic | 0 | 0.0 | 1 | 1.4 | 1 | 1.4 | 39 | 54.2 | 31 | 43.1 |
The sessions were challenging | 0 | 0.0 | 0 | 0.0 | 1 | 1.4 | 30 | 41.7 | 41 | 56.9 |
The sessions prompted realistic responses from me | 0 | 0.0 | 1 | 1.4 | 8 | 12.5 | 31 | 43.1 | 31 | 43.1 |
The sessions should be taken by all emergency staff | 0 | 0.0 | 0 | 0.0 | 1 | 1.4 | 25 | 34.7 | 46 | 63.9 |
Protocol | ||||||||||
The Protocol handbook was easy to use | 0 | 0.0 | 0 | 0.0 | 3 | 3.9 | 35 | 46.1 | 38 | 50.0 |
The font was clear and easy to read | 0 | 0.0 | 0 | 0.0 | 1 | 1.3 | 24 | 31.6 | 51 | 67.1 |
I prefer linear steps to flowcharts | 1 | 1.3 | 2 | 2.6 | 21 | 27.6 | 25 | 32.9 | 27 | 35.5 |
The Protocol handbook helped me to manage these emergencies | 0 | 0.0 | 0 | 0.0 | 1 | 1.3 | 29 | 38.7 | 45 | 60.0 |
I would use the Protocol handbook if presented with these emergencies in real life | 0 | 0.0 | 0 | 0.0 | 2 | 2.6 | 17 | 22.4 | 57 | 75.0 |
If I, or a family member, experienced these emergencies, I would want the Protocol handbook used | 0 | 0.0 | 0 | 0.0 | 5 | 6.6 | 20 | 26.3 | 51 | 67.1 |
Overall quality | Unacceptable | Poor | Fair | Good | Excellent | |||||
Sessions | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 15 | 20.8 | 57 | 79.2 |
Protocol handbook | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 14 | 18.4 | 61 | 80.3 |