Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study
Abstract BackgroundEffective crisis management in operating rooms (ORs) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions. ObjectiveThe objective of this study w...
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JMIR Publications
2025-01-01
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| Series: | JMIR XR and Spatial Computing |
| Online Access: | https://xr.jmir.org/2025/1/e60792 |
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| author | Rayan Ebnali Harari Abdullah Altaweel Erik Anderson Charles Pozner Rafael Grossmann Andrew Goldsmith Hamid Shokoohi |
| author_facet | Rayan Ebnali Harari Abdullah Altaweel Erik Anderson Charles Pozner Rafael Grossmann Andrew Goldsmith Hamid Shokoohi |
| author_sort | Rayan Ebnali Harari |
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Abstract
BackgroundEffective crisis management in operating rooms (ORs) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions.
ObjectiveThe objective of this study was to evaluate the efficacy of augmented reality (AR)-enhanced checklists in improving protocol adherence, compared to traditional paper checklists and no checklist scenarios during simulated OR crises.
MethodsThis study was a randomized comparative efficacy study comparing the utility of AR checklists, paper checklists, and no checklist scenarios using 4 validated and simulated OR crises scenarios: asystolic cardiac arrest, air embolism, unexplained hypotension/hypoxia, and malignant hyperthermia. The study took place in a simulated OR setting and had applicability to the standard procedures in ORs, critical care units, and urgent care scenarios in the emergency department. To form the 24 OR teams, 50 professionals including 24 anesthesiologists, 24 nurses, 1 surgeon, and 1 scrub nurse from two academic hospitals were included. The primary outcome measured was the failure to adhere (FTA) rate for critical actions during simulated OR crises. Adherence was determined using retrospective video analysis involving 595 key processes evaluated across 24 surgical teams. Interrater reliability was assessed using a Cohen κ. Secondary outcomes included checklist usability and cognitive load, as measured by the low-frequency to high-frequency (LF/HF) ratio of the heart rate variability.
ResultsThe AR checklist group showed a significantly lower FTA rate (mean 15.1%, SD 5.77%) compared to the paper checklist (mean 8.32%, SD 5.65%; t23Pt23PF2,46P
ConclusionsThese results suggest that AR checklists could offer a viable method for enhancing adherence to critical care protocols. Although, further research is needed to fully assess their impact on clinical outcomes and to address any associated increase in cognitive load. |
| format | Article |
| id | doaj-art-1b9329a57bc04835aba9a969d441df0f |
| institution | Kabale University |
| issn | 2818-3045 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
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| series | JMIR XR and Spatial Computing |
| spelling | doaj-art-1b9329a57bc04835aba9a969d441df0f2025-01-22T13:00:59ZengJMIR PublicationsJMIR XR and Spatial Computing2818-30452025-01-012e60792e6079210.2196/60792Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy StudyRayan Ebnali Hararihttp://orcid.org/0009-0007-7494-0758Abdullah Altaweelhttp://orcid.org/0000-0002-6769-6415Erik Andersonhttp://orcid.org/0009-0009-2635-3633Charles PoznerRafael GrossmannAndrew GoldsmithHamid Shokoohi Abstract BackgroundEffective crisis management in operating rooms (ORs) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions. ObjectiveThe objective of this study was to evaluate the efficacy of augmented reality (AR)-enhanced checklists in improving protocol adherence, compared to traditional paper checklists and no checklist scenarios during simulated OR crises. MethodsThis study was a randomized comparative efficacy study comparing the utility of AR checklists, paper checklists, and no checklist scenarios using 4 validated and simulated OR crises scenarios: asystolic cardiac arrest, air embolism, unexplained hypotension/hypoxia, and malignant hyperthermia. The study took place in a simulated OR setting and had applicability to the standard procedures in ORs, critical care units, and urgent care scenarios in the emergency department. To form the 24 OR teams, 50 professionals including 24 anesthesiologists, 24 nurses, 1 surgeon, and 1 scrub nurse from two academic hospitals were included. The primary outcome measured was the failure to adhere (FTA) rate for critical actions during simulated OR crises. Adherence was determined using retrospective video analysis involving 595 key processes evaluated across 24 surgical teams. Interrater reliability was assessed using a Cohen κ. Secondary outcomes included checklist usability and cognitive load, as measured by the low-frequency to high-frequency (LF/HF) ratio of the heart rate variability. ResultsThe AR checklist group showed a significantly lower FTA rate (mean 15.1%, SD 5.77%) compared to the paper checklist (mean 8.32%, SD 5.65%; t23Pt23PF2,46P ConclusionsThese results suggest that AR checklists could offer a viable method for enhancing adherence to critical care protocols. Although, further research is needed to fully assess their impact on clinical outcomes and to address any associated increase in cognitive load.https://xr.jmir.org/2025/1/e60792 |
| spellingShingle | Rayan Ebnali Harari Abdullah Altaweel Erik Anderson Charles Pozner Rafael Grossmann Andrew Goldsmith Hamid Shokoohi Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study JMIR XR and Spatial Computing |
| title | Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study |
| title_full | Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study |
| title_fullStr | Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study |
| title_full_unstemmed | Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study |
| title_short | Augmented Reality in Enhancing Operating Room Crisis Checklist Adherence: Randomized Comparative Efficacy Study |
| title_sort | augmented reality in enhancing operating room crisis checklist adherence randomized comparative efficacy study |
| url | https://xr.jmir.org/2025/1/e60792 |
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