How Does Task Loading in PICU Impact on Clinician Situational Awareness and Awareness of the Passage of Time?

NCT05383222 | Unknown

• 1 other identifier: 21HL15
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

There is little published literature on the subject of clinician perception of trends in patient observations on PICUs (Paediatric Intensive Care Units) and how this situational awareness is impacted on by clinical tasks. Human factors training cautions against the loss of situational awareness and time perception but there is no supporting observational data in the IC (Paediatric Intensive Care) setting. Perceptual loading theory hypothesises that, under low load situations, awareness extends to environmental features not directly related to the task at hand. However in high load situations awareness is restricted to the object of focused attention. Individuals experience different load from a given task depending on their skills and experience. Our pilot project intends to examine how clinician perception is affected by task loading. In our protocol two tasks are undertaken. The administrative task involves requesting a list of investigations from a clinical guideline. The technical task is the uncomplicated insertion of a central venous catheter (CVC) into a simulated vein. In each case the investigators will record proxies for perception: awareness of the passage of time, the time point at which monitoring changes are noted and retrospective recall of observation trends. Our protocol was designed with psychology input from Prof. Nilli Lavie, group leader of the UCL Attention \& Cognitive Control laboratory. Passage of time is measured by the participant pressing a foot pedal linked to timing software at every perceived 10 second interval of elapsed time. A retrospective estimate of total elapsed time will also be recorded. After the second task, immediate verbal questions are asked followed by a written questionnaire which contains questions targeting the participant's awareness of monitoring changes. Analysis will involve paired t testing of the timing interval and observation trend data to see if task loading significantly impacts accuracy.

Conditions

Clinician Perception; Clinician Attention

Keywords

Perception; Attention; Trend awareness

Outcome Measures

Primary Outcomes (4)

• Prospective identification of monitoring trends

  Proportion (%) of clinicians who correctly identify any change in the monitored parameters during the tasks. Measured through post task questionnaire

  Following recruitment of the 30th participant- expected 3 months after starting recruitment

• Retrospective identification of monitoring trends

  Proportion (%) of clinicians who correctly identify any change in the monitored parameters following the tasks. Measured through post task questionnaire

  Following recruitment of the 30th participant- expected 3 months after starting recruitment

• Retrospective identification of the magnitude of the change in monitoring

  Percentage error in the retrospectively recalled magnitude of the change in monitored parameters, compared to the actual change in value. Measured through comparison of the post task questionnaire answers to the actual change.

  Following recruitment of the 30th participant- expected 3 months after starting recruitment

• Accuracy of clinician time perception

  As compared to the actual 10s elapsed time interval. Measured through the computer logging timestamps of foot pedal presses vs computed measured 10s interval

  Following recruitment of the 30th participant- expected 3 months after starting recruitment

Study Arms (2)

ICU clinicians- technical first

EXPERIMENTAL

Staff working on the Great Ormond Street ICUs Completing technical task first

Behavioral: Technical task; Behavioral: Administrative task

ICU clinicians- administrative first

EXPERIMENTAL

Staff working on the Great Ormond Street ICUs Completing administrative task first

Behavioral: Technical task; Behavioral: Administrative task

Interventions

Technical task BEHAVIORAL

Simulated insertion of a central venous catheter

ICU clinicians- administrative first; ICU clinicians- technical first

Administrative task BEHAVIORAL

Requesting a battery of investigations on the EPR

ICU clinicians- administrative first; ICU clinicians- technical first

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \. Medical staff working on the Great Ormond Street ICUs

You may not qualify if:

• \. Staff identifying as unable to insert central venous catheters

Sponsors & Collaborators

• Great Ormond Street Hospital for Children NHS Foundation Trust: lead
• University College, London: collaborator

Study Sites (1)

Great Ormond Street PICU

London, WC1N 3JH, United Kingdom

Location

Central Study Contacts

James Diviney

CONTACT

07739344890; james.diviney@nhs.net

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Participants
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants complete 2 tasks, the order of which is randomised.

Study Record Dates

• First Submitted: December 1, 2021
• First Posted: May 20, 2022
• Study Start: September 1, 2022
• Primary Completion: September 1, 2022
• Study Completion: November 1, 2022
• Last Updated: May 20, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)