Trial Outcomes & Findings for Reducing Prehospital Medication Errors & Time to Drug Delivery by EMS During Simulated Pediatric CPR (NCT NCT03921346)

Race and Ethnicity were not collected from any participant.

To measure in each allocation group the number and percentage of medication dosage containing errors that occur during the sequence from drug preparation to drug injection. We define an emergency medication dose administration error as a failure in drug preparation if at least one of the following errors is committed: a deviation in drug dose of more than 10% from the correct weight dose; inability to calculate drug dosage without guidance help from the paramedic investigator (LB) leading the resuscitation in the room; and/or (because of its clinical relevance) a deviation of more than 10% of the final administered concentration of sodium bicarbonate from the prescribed 4.2% concentration. These errors will be measured both as the percentage deviation from the amount of delivered drug compared with the correct weight dose as prescribed by the physician and the absolute deviations from that dose.

Secondary outcome will be the elapsed time in seconds between the oral prescription by the physician and a) time to drug preparation completion and b) time to drug delivery by the participant.

Incorrect preparations: a) drug dose deviation \>10% from the correct dose prescribed by the physician, b) drug preparation necessitating assistance (i.e., inability for the nurse to prepare the prescribed drug without the help of a third party), and c) \>10% deviation from the prescribed drug dose in the 4th drug concentration will be reported.

Participants' self-assessed psychological stress will be measured before and after the intervention (ie. drug preparation) using the Gauthier and Bouchard's French-Canadian adaptation of Spielberger's psychometric State-Trait Anxiety Inventory (STAI) Form Y-1 questionnaire. STAI ranges from 20 to 80, with higher scores being positively correlated with greater stress. Perceived stress will also be assessed by self-assessment using a numerical 10-point Likert visual analogue scale (VAS). Values range from 1 (totally unstressed) to 10 (totally stressed) to avoid neutral answers. The perceived stress before the preparation of the 4 drugs and after the preparation of the 4 drugs will be indicated for each study arm. In other words, the perceived stress will not be given for each of the 4 drugs individually, but as a single value before and a single value after the drug preparation, for both the STAI and the VAS.

The participants' stress level will be assessed by measuring continuously their heart rate using a Polar A360 smartwatch on their wrist during the resuscitation scenario. Mean delta HR values (difference between HR peak values and baseline HR) will be obtained during some small segments of scenario and correlated to the scenario phases and the preparation methods used.

Unified Theory of Acceptance and Use of Technology (UTAUT): a 52-item questionnaire distributed in 8 core constructs: 1) perceived usefulness (4 items), 2) perceived ease of use (4 items), 3) task-technology fit (4 items), 4) performance expectancy (3 items), 5) impact on image (2 items), 6) personal innovativeness (3 items), 7) acceptance (3 items), and 8) behavioral intention to use the technology (3 items). Each construct are based on a Likert-type 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). Increments are integers between 1 to 5. Min score per construct = 1, max score per construct = 5. The higher the score, the better the acceptance. System Usability Score (SUS): Comprises a 10-item questionnaire with 5 response options for each item, ranging from 1 (strongly disagree) to 5 (strongly agree). The higher the score, the better the usability (ie, 0=very poor perceived usability and 100=excellent perceived usability)