Speakers - WNSC 2023

Abstract

Aim: Traditional paper-based documentation is often inaccurate and incomplete of time and events. Electronic documentation for cardiopulmonary arrest (CPA) events supports appropriate process improvements and optimal patient care while readjusting national benchmarks with more accurate data.

Method: Nurses on 4 Medical-Surgical units received training on a handheld electronic documentation application (Code Pro) to document live CPA events. All events downloaded into an Excel file were compared to the LifePak15 defibrillator downloads using the CODE-STAT 10.0 software for completeness, accuracy, and timing. Electronic and traditional paper documentation events, collected on the same pilot units 4 months previous to the pilot, were both assessed against the CODE-STAT 10.0 for comparison of documentation.

Results: There were 26 total observations. 6 cases were captured using the electronic application, 8 using paper-based worksheets, and 12 using paper-based on the pilot units (which were excluded). The data accuracy in the electronic group was significantly higher as compared to the paper-based group for recorded rhythm (accuracy 100% vs. 13%, p-value = 0.01) and end-tidal carbon dioxide (67% vs 0%, p-value = 0.02). The electronic method significantly outperformed the paper-based process in legibility (100% vs. 13%, p-value < 0.01). Staff reported significant satisfaction in utilizing electronic vs. paper-based documentation.

Conclusion: When compared to electronic handheld app-based documentation during live resuscitation events, the inaccuracies of paper-based documentation were reinforced. Electronic documentation was far superior in overall quality of documentation and related to the initial rhythm of the event. A larger study using electronic documentation, capturing more VF/VT arrests, would show a greater accuracy of the timing of events, which will have a large impact on overall resuscitation quality improvements and guidelines for patient care.