Using educational video to enhance protocol adherence for medical procedures.
BACKGROUND
Better education of clinicians is expected to enhance patient safety. An important component of education is adherence to standard protocols, which are mainly available in written form. Believing in the potential power of videos, we hypothesized that the introduction of an educational video, based on an institutional standard protocol, would foster adherence to the protocol.


METHODS
We conducted a prospective intervention study of 425 anaesthesia procedures and teams (202 pre-video and 223 post-video) involving 1091 team members (516 pre-video and 575 post-video) in seven individual operating areas (with a total of 30 operating rooms) in a university hospital. Failure of adherence to safety-critical tasks during rapid sequence anaesthesia inductions was assessed during systematic on-site observations pre- and post-introduction of an educational video demonstrating evidence-based and best practice guidelines.


RESULTS
The odds for failure of adherence to safety-critical tasks between the pre- and post-intervention period were reduced, odds ratio 0.34 (95% confidence interval 0.27-0.42, P<0.001). The risk for failure of adherence was reduced significantly for eight of the 14 safety-critical tasks (all P<0.001).


CONCLUSIONS
This study provides empirical evidence for the effectiveness of an educational video to enhance adherence to a standard protocol during complex medical procedures. The introduction of a video can reduce failure of adherence to safety-critical tasks and contribute to patient safety. We recommend the introduction of videos to improve protocol adherence.
Institute of Anaesthesiology, University and University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
Lukas
L
Kandler
Institute of Anaesthesiology, University and University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
David W
DW
Tscholl
Organization, Work and Technology Group, ETH Zurich, Weinbergstrasse 56/58, 8092 Zurich, Switzerland Quality Management and Patient Safety, University and University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
Michaela
M
Kolbe
Biostatistics, Epidemiology, and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland.
Burkhardt
B
Seifert
Institute of Anaesthesiology, University and University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.
Donat R
DR
Spahn
Institute of Anaesthesiology, University and University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland christoph.noethiger@usz.ch.
Christoph B
CB
Noethiger
D000758:Anesthesia / Q000592:standards*; D000776:Anesthesiology / Q000193:education*; D001296:Audiovisual Aids; D004502:Education, Medical, Continuing / Q000379:methods*; D004509:Education, Nursing, Continuing / Q000379:methods; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D015588:Observer Variation; D061214:Patient Safety; D013527:Perioperative Nursing / Q000193:education / Q000592:standards; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D058996:Quality Improvement; D013557:Switzerland; D013664:Teaching Materials; D014741:Video Recording
guideline adherence; instructional films and video; patient safety; quality improvement; safety