Innovation in resuscitation: A novel clinical decision display system for advanced cardiac life support.

INTRODUCTION: The Advanced Cardiac Life Support (ACLS) Clinical Decision Display System (CDDS) is a novel application designed to optimize team organization and facilitate decision-making during ACLS resuscitations. We hypothesized that resuscitation teams would more consistently adhere to ACLS guideline time intervals in simulated resuscitation scenarios with the CDDS compared to without. METHODS: We conducted a simulation-based, non-blinded, randomized, crossover-design study with resuscitation teams comprised of Emergency Medicine physicians, registered nurses, critical care technicians, and paramedics. Each team performed 4 ACLS scenarios in randomized sequences, half with the CDDS and half without. We analyzed the resuscitations and recorded the times of interventions that have defined intervals by ACLS: rhythm checks, epinephrine administration, and shock delivery. In addition, we surveyed each resuscitation team regarding their experience using the CDDS. RESULTS: On average, teams performed rhythm checks 4.9 s closer to ACLS guidelines with the CDDS (p = 0.0358). Teams were also more consistent; on average, teams reduced the variation of time between consecutive doses of epinephrine by 45% (p = 0.0001) and defibrillation by 47% (p < 0.0001). Ninety-eight percent of participants indicated they would use the CDDS if available in real cardiac arrests. CONCLUSIONS: This study demonstrates that the CDDS improves the accuracy and precision of timed ACLS interventions in a simulated setting. Resuscitation teams were strongly in favor of utilizing the CDDS in clinical practice. Further investigations of the introduction of the platform into real time clinical environments will be needed to assess true efficacy and patient outcomes.

Classifying Residents who use Landscape Irrigation: Implications for Encouraging Water Conservation Behavior.

Large amounts of water applied as urban irrigation can often be reduced substantially without compromising esthetics. Thus, encouraging the adoption of water-saving technologies and practices is critical to preserving water resources, yet difficult to achieve. The research problem addressed in this study is the lack of characterization of residents who use urban irrigation, which hinders the design of effective behavior change programs. This study examined audience segmentation as an approach to encouraging change using current residential landscape practices. K-means cluster analysis identified three meaningful subgroups among residential landscape irrigation users (N = 1,063): the water considerate majority (n = 479, 45 %), water savvy conservationists (n = 378, 36 %), and unconcerned water users (n = 201, 19 %). An important finding was that normative beliefs, attitudes, and perceived behavioral control characteristics of the subgroups were significantly different with large and medium practical effect sizes. Future water conservation behaviors and perceived importance of water resources were also significantly different among subgroups. The water considerate majority demonstrated capacity to conserve, placed high value on water, and were likely to engage in behavior changes. This article contributes to the literature on individuals who use residential landscape irrigation, an important target audience with potential to conserve water through sustainable irrigation practices and technologies. Findings confirm applicability of the capacity to conserve water to audience segmentation and extend this concept by incorporating perceived value of water resources and likelihood of conservation. The results suggest practical application to promoting residential landscape water conservation behaviors based on important audience characteristics.

The Association between Emergency Department Super-Utilizer Status and Willingness to Participate in Research.

BACKGROUND: Research based on emergency departments (EDs) primarily focuses on medical conditions. There is limited research that investigates patients who willingly participate in research. This current study explored ED super-utilizers' (SUs') and nonsuper-utilizers' (NSUs') attitudes toward research. OBJECTIVE: The study assesses the willingness of SUs to participate in research. We hypothesize that the SU population will be as interested as nonutilizers in participating in medical research. METHODS: This prospective observational study stratified participants into SU and NSU cohorts based on their self-reported number of ED visits within 6 months. Surveys were captured in a secured database and analyzed using SAS 9.4. RESULTS: 7,481 completed questionnaires. SUs were more interested in participating in all types of research compared to NSUs. Both groups were most willing to participate in surveys. Neither group was particularly interested in studies that required medications. SUs were not more willing to participate in studies without payment than NSUs. Both groups trusted researchers at the same rates. CONCLUSION: Although rarely included in medical research, SUs were more willing to participate in nearly all types of research and expressed a similar trust in medical research when compared to nonsuper-utilizers.