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Electronic Decision Support in the Delivery Room Using Augmented Reality to Improve Newborn Life Support Guideline
Kishan D Tsang1, Mendel K Ottow, Arno F J van Heijst
1From the Division of Neonatology, Department of Pediatrics (K.D.T., A.F.J.v.H., T.A.J.A.), and Department of Pediatrics (M.K.O.), Radboud University Medical Centre Amalia Children's Hospital, Nijmegen, the Netherlands.
Introduction:
The Newborn Life Support (NLS) guideline aims to provide healthcare professionals a consistent approach during neonatal resuscitation. Adherence to this and analogous guidelines has repetitively been proven to be difficult.This study evaluates adherence to guideline using a novel augmented reality (Microsoft HoloLens) electronic decision support tool during standardized simulated neonatal resuscitation compared with subjects working from memory alone.
Methods:
In this randomized controlled pilot study, 18 professionals responsible for neonatal resuscitation were randomized to the intervention group and 11 to the control group. Demographic characteristics were similar between both groups. A standardized neonatal resuscitation scenario was performed, which was recorded and later assessed for adherence to the NLS algorithm by 2 independent reviewers. Secondary outcomes were error classification in case of algorithm deviation and time to the execution or completion of critical steps in the algorithm to determine delay.
Results:
Median (interquartile range) scores of a theoretical maximum of 40 in the intervention group were 34 (32.5-35.5) versus 29 (27-33) in the control group ( P = 0.004). Errors of commission were committed less frequently with the electronic decision support tool 2 (1-2.5) compared with 4 (2-4) in the control group ( P = 0.029). Analysis of time to initiation or completion of key steps in the NLS algorithm showed no significant differences between both groups.
Conclusions:
Healthcare professionals using an electronic decision support tool showed improved adherence to the NLS guideline during simulated neonatal resuscitation.
