title: Tablet-based cardiac arrest documentation: a pilot study.
abstract: OBJECTIVE
  Conventional paper-based resuscitation transcripts are notoriously inaccurate, often lacking the precision that is necessary for recording a fast-paced resuscitation. The aim of this study was to evaluate whether a tablet computer-based application could improve upon conventional practices for resuscitation documentation.
  
  
  METHODS
  Nurses used either the conventional paper code sheet or a tablet application during simulated resuscitation events. Recorded events were compared to a gold standard record generated from video recordings of the simulations and a CPR-sensing defibrillator/monitor. Events compared included defibrillations, medication deliveries, and other interventions.
  
  
  RESULTS
  During the study period, 199 unique interventions were observed in the gold standard record. Of these, 102 occurred during simulations recorded by the tablet application, 78 by the paper code sheet, and 19 during scenarios captured simultaneously by both documentation methods These occurred over 18 simulated resuscitation scenarios, in which 9 nurses participated. The tablet application had a mean sensitivity of 88.0% for all interventions, compared to 67.9% for the paper code sheet (P=0.001). The median time discrepancy was 3s for the tablet, and 77s for the paper code sheet when compared to the gold standard (P<0.001).
  
  
  CONCLUSIONS
  Similar to prior studies, we found that conventional paper-based documentation practices are inaccurate, often misreporting intervention delivery times or missing their delivery entirely. However, our study also demonstrated that a tablet-based documentation method may represent a means to substantially improve resuscitation documentation quality, which could have implications for resuscitation quality improvement and research.
authors.affiliation: Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Peace
authors.affiliation: Section of Hospital Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Trevor C
authors.initials: TC
authors.lastname: Yuen
authors.affiliation: Section of Hospital Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Meredith H
authors.initials: MH
authors.lastname: Borak
authors.affiliation: Section of Hospital Medicine, University of Chicago, Chicago, IL, United States. Electronic address: dperes@uchicago.edu.
authors.forename: Dana P
authors.initials: DP
authors.lastname: Edelson
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education* / Q000592:standards; D002641:Chicago; D034201:Computers, Handheld; D004282:Documentation / Q000592:standards*; D005260:Female; D006323:Heart Arrest / Q000451:nursing*; D006801:Humans; D007318:Inservice Training; D008297:Male; D010348:Patient Care Team / Q000592:standards; D010865:Pilot Projects; D011446:Prospective Studies; D014584:User-Computer Interface
keywords: Cardiopulmonary resuscitation; Code sheet, Cardiac arrest documentation