title: The effectiveness of an intensive care quick reference checklist manual--a randomized simulation-based trial.
abstract: OBJECTIVE
  We aimed to test the effectiveness of checklists for emergency procedures on medical staff performance in intensive care crises.
  
  
  METHODS
  This is a prospective single-center randomized trial in a high-fidelity simulation center modeling an intensive care unit (ICU) in a tertiary care hospital in Germany. Teams consisted of 1 ICU resident and 2 ICU nurses (in total, n = 48). All completed 4 crisis scenarios, in which they were randomized to use checklists or to perform without any aid. In 2 of the scenarios, checklists could be used immediately (type 1 scenarios); and for the remaining, some further steps, for example, confirming diagnosis, were required first (type 2 scenarios). Outcome measurements were number of predefined items and time to completion of more than 50% and more than 75% of steps, respectively.
  
  
  RESULTS
  When using checklists, participants initiated items faster and more completely according to appropriate treatment guidelines (9 vs 7 items with and without checklists, P < .05). Benefit of checklists was better in type 2 scenarios than in type 1 scenarios (2 vs 1 additional item, P < .05). In type 2 scenarios, time to complete 50% and 75% of items was faster with the use of checklists (P < .005).
  
  
  CONCLUSIONS
  Use of checklists in ICU crises has a benefit on the completion of critical treatment steps. Within the type 2 scenarios, items were fulfilled faster with checklists. The implementation of checklists for intensive care crises is a promising approach that may improve patients' care.
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Katja S
authors.initials: KS
authors.lastname: Just
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Svenja
authors.initials: S
authors.lastname: Hubrich
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schmidtke
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Scheifes
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Mark U
authors.initials: MU
authors.lastname: Gerbershagen
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Wappler
authors.affiliation: University Witten/Herdecke, Medical Center Cologne-Merheim, Department of Anesthesiology and Intensive Care Medicine, Ostmerheimer St 200, 51109 Cologne, Germany. Electronic address: grensemannj@kliniken-koeln.de.
authors.forename: Joern
authors.initials: J
authors.lastname: Grensemann
mesh_terms: D000368:Aged; D057189:Checklist; D003422:Critical Care / Q000458:organization & administration*; D005260:Female; D005858:Germany; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D058996:Quality Improvement / Q000458:organization & administration*
keywords: Checklist; Critical care; Emergencies; Intensive care; Simulation