Managing Simulated Anesthesia Emergencies with the Use of Clinical Decision Support Systems in a Rural Hospital Setting

Certified registered nurse anesthetists (CRNAs) regularly encounter stressful emergency situations that demand critical thinking and quick intervention; these scenarios often result in task saturation and compromised mental acuity. An intervention utilizing a clinical decision support system (CDSS) with anesthesia emergency checklists built into the electronic health record (EHR) at a rural hospital in New Mexico was tested in a simulated environment. The simulation compared CRNA performance and adherence to evidence-based protocols with and without the checklists. The purpose of this study was to determine whether a CDSS built into the existing EHR could improve both CRNAs' adherence to evidence-based protocols and their documentation during an acute malignant hyperthermia (MH) emergency. Quantitative methods were used in the analysis of the data. Descriptive statistics and a paired t test were used to analyze MH evaluation tool data. Measures of central tendency were used to identify trends in the data. The study showed significant improvement (<i>P</i> < .05) in CRNA performance while using a CDSS during a simulated MH emergency and dramatic increases in documentation completeness.