A review of the use of cognitive aids in crisis management

Oleksiy Solonwicz, RN, DNP, CRNA

DNP Nurse Anesthesia 

A review of the use of cognitive aids in crisis management

Project Category: Evidence Synthesis

Project Team: Oleksiy Solonowics, DNP, CRNA  Ana Garcia, DNP, CRNA, Ginna Kim, DNP, CRNA, APNP (Advisor)

Abstract

Background: Medical emergencies produce stressful circumstances requiring rapid data interpretation, diagnosis, and implementation of the appropriate treatment. Cognitive aids (CAs) are a written or electronic means of providing evidence-based guidance to manage emergencies. However, despite evidence supporting their use, CA implementation and widespread use remain challenging.

Methods: An integrative literature review was conducted using a systematic search of PubMed, CINHAL Complete, and Google Scholar. Keywords searched included: "cognitive aids," "emergency manual," "manuals as a topic," "electronic cognitive aid," and "digital cognitive aid." Articles for inclusion focused on healthcare providers from all fields and their use of electronic or printed CAs. Two independent reviewers appraised each of the studies, and the evidence was organized by the type of CA, setting, participants, and primary and secondary outcomes.   

Results: The review included 23 studies. Samples ranged from six to 106 participants. Many included studies were randomized control trials. One of the studies involved a live environment, while the remainder were conducted in simulated environments. The studies included investigated technical performance as a primary outcome and non-technical skills as a secondary. Groups that utilized either CA type saw improvement in technical performance.

Conclusions: Regardless of CA type, most studies reported that participants utilizing CAs had improved task and non-technical performance than those using memory alone, making CAs a valuable tool for health care providers to adhere to best practices during emergencies.

Full Manuscript