Cognitive Aids With Roles Defined (CARD) for Obstetrical Crises: A Multisite Cohort Study

NCT02093078 | Completed

• 1 other identifier: 20120926-01H
• Study Type: observational
• Target: 346
• Locations: 1 country
• Sites: 1

Brief Summary

Crisis resource management represents the set of non technical skills, such as communication, leadership, delegation, and prioritization, that allow effective teamwork for optimal patient care during an urgent and critical situation. The Cognitive Aids with Roles Defined (CARD) is a new concept of cognitive aid addressing the well-documented issue of teamwork in crisis management. It relies on large identification cards specially designed for each team members profession and role. During a life threatening clinical situation, the CARD protocol focuses on clarification of individual roles and distribution of tasks for crisis management rather than creating an additional algorithm identifying either a list of actions to be taken or the dose of a medication. This study aims to evaluate the clinical impact of introducing the CARD protocol in obstetrical emergency situations ("code 333") in clinical practice at The Ottawa Hospital. Hypothesis: CARD protocol will: (i) decrease the total time taken to deliver the baby, and (ii) improve clinical outcome for the mother and baby compared to traditional management without the CARD protocol.

Conditions

Obstetrical Emergency Situations

Outcome Measures

Primary Outcomes (1)

• Total Time to Delivery After a Code 333

  The primary outcome measure is the exact time from when the code 333 is called, to the time of delivery (up to 1 day).

  from the time of calling in a code 333 to the time of birth (up to 1 day).

Secondary Outcomes (1)

• standard clinical outcomes on patient charts

  participants will be followed from when the code 333 was called until hospital discharge or mortality, whichever comes first (up to 3 years).

Study Arms (2)

CARD

Intervention: CARD This group will be introduced to the CARD protocol which focuses on clarification of individual roles and distribution of tasks. It relies on large identification cards specially designed for each team member's profession and role. Each card worn by a team member identifies the specific tasks associated with that individual's role. CARD enables the team leader and other team members to quickly recognize everyone's role at the code, and each team member can commence their assigned tasks without delay.

Behavioral: CARD

Control Arm

Interventions

CARD BEHAVIORAL

Intervention: CARD This group will be introduced to the CARD protocol which focuses on clarification of individual roles and distribution of tasks. It relies on large identification cards specially designed for each team member's profession and role. Each card worn by a team member identifies the specific tasks associated with that individual's role. CARD enables the team leader and other team members to quickly recognize everyone's role at the code, and each team member can commence their assigned tasks without delay.

CARD

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Twelve obstetrical unit teams (4 registered nurses (RN), 1 operating room attendant, 1 respiratory therapist (RT) assisting anesthesia, 1 RT assisting neonatal, 2 neonatal RNs) will be recruited for the study

You may qualify if:

• must hold a staff position at The Ottawa Hospital (Civic or General campus) in one of the following positions:
• registered nurses (RN)
• operating room attendant
• respiratory therapist (RT)
• assisting anesthesia
• RT assisting neonatal
• neonatal RNs

You may not qualify if:

• not a staff member at The Ottawa Hospital (Civic or General campus)
• holding a position that is different from any of the following: registered nurse, operating room attendant, respiratory therapist, assisting anesthesia, RT assisting neonatal, neonatal RN
• investigators involved in the study

Sponsors & Collaborators

• Ottawa Hospital Research Institute: lead
• Canadian Anesthesiologists' Society: collaborator
• The Ottawa Hospital Academic Medical Association: collaborator

Study Sites (1)

The Ottawa Hospital

Ottawa, Ontario, Canada

Location

Study Officials

• Sylvain Boet, MD

  The Ottawa Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 7, 2014
• First Posted: March 20, 2014
• Study Start: January 1, 2014
• Primary Completion: December 31, 2017
• Study Completion: December 31, 2017
• Last Updated: September 7, 2018

Record last verified: 2018-09

Locations

CA (1)