Tschan, Franziska

2009, Bogenstätter, Yvonne, Tschan, Franziska, Semmer, Norbert, Spychiger, Martin, Breuer, Marc, Marsch, Stephan

Objective: This study used a high-fidelity simulation to examine factors influencing the accuracy of 201 pieces of information transmitted to nurses and physicians joining a medical emergency situation. Background: Inaccurate or incomplete information transmission has been identified as a major problem in medicine. However, only a few studies have assessed possible causes of transmission errors. Method: Each of 20 groups was composed of two or three nurses (first responders), one resident joining the group later, and one senior doctor joining last. Groups treated a patient suffering a cardiac arrest. Results: Multilevel binomial analyses showed that 18% of the information given to newcomers was inaccurate. Quantitative information requiring repeated updating was particularly error prone. Information generated earlier (i.e., older information) was more likely to be transmitted inaccurately. Explicitly encoding information to be transmitted after the physicians arrived at the scene enhanced accuracy, supporting transfer-appropriate processing theory. Conclusion: Information transmitted to nurses and physicians who join an ongoing emergency is only partly reliable. Therefore, medical professionals should not take accuracy for granted and should be aware of the nature of transmission errors. Application: Medical professionals should be trained in adequate encoding of information and in standardized communication procedures with regard to error-prone information. In addition, technical devices should be implemented that reduce reliance on memory regarding information with error-prone characteristics.