The Effect of Electronic Record Keeping and Transesophageal Echocardiography on Task Distribution, Workload, and Vigilance During Cardiac Anesthesia

摘要: BACKGROUND Electronic anesthesia record keeping (EARK) systems increasingly are used in the operating room, but studies have only recently begun to investigate their effect on task performance. Teak analysis, workload assessment, and vigilance assessment techniques were study senior residents providing for coronary artery bypass graft (CABG) procedures. The impact residents' of routine use transesophageal echocardiography (TEE) also was examined. METHODS Before each case, system randomly selected as either electronic (Distek ARKIVE; EARK) or traditional manual recording (MAN). Twenty CABG procedures (10 EARK 10 MAN) examined, with observation commencing anesthetic induction terminating initiation cardiopulmonary bypass. activities resident, divided into 32 categories (e.g., "laryngoscopy," "observe monitors," etc.), recorded by a trained observer using computer. response latency activated alarm light measure ("vigilance latency"). Workload rated subject at random 10- 15-min intervals throughout case. Data analysis included calculation density (number tasks/min multiplied task-specific values) task-links (relationship between sequential tasks). RESULTS two groups had similar distribution tasks before intubation. In 4 20 cases studied did any occur After intubation, group spent less time TEE more observing monitors conversing attending physician than MAN did. All subjects reported significantly higher scores intubation compared after Similarly, greater (57 vs. 31 s; P < 0.001). There no significant differences subjective scores, density, latency. During use, longer, during other monitoring tasks. CONCLUSIONS This provides an objective description administration cardiac surgery. Under conditions this study. modestly decreased postintubation prebypass period. However, there several measures workload. associated increased possibly vigilance.