Evaluating the test re-test reliability and inter-subject variability of health care provider manual fluid resuscitation performance

BMC Research Notes

Lehana Thabane⁴  Lawrence Mbuagbaw¹  Frank MH Lee³  Melissa J Parker² 

[1] Biostatistics Unit,/FSORC, St Joseph's Healthcare Hamilton, 3rd floor Martha Wing 50 Charlton Avenue East, Hamilton L8N 4A6, Canada;Division of Critical Care, Department of Pediatrics, McMaster Children’s Hospital and McMaster University, 1280 Main St. W, Room 3Y, Hamilton, Ontario L8S 4K1, Canada;Department of Pediatrics, McMaster Children’s Hospital and McMaster University, 1280 Main St W. Room 3A, Hamilton, Ontario L8S 4K1, Canada;Department of Anesthesia, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4K1, Canada

关键词: Pediatrics;    Fluid therapy;    Shock;    Resuscitation;    Research methods;   

Others  :  1127261
DOI  :  10.1186/1756-0500-7-724

 received in 2014-02-05, accepted in 2014-09-25,  发布年份 2014

【 摘 要 】

Background

Health Care Providers (HCPs) report that manual techniques of intravascular fluid resuscitation are commonly used during pediatric shock management. The optimal pediatric fluid resuscitation technique is currently unknown. We sought to determine HCP test-retest reliability (repeatability) and inter-subject variability of fluid resuscitation performance outcomes to inform the design of future studies.

Methods

Fifteen consenting HCPs from McMaster Children’s Hospital, in Hamilton, Canada participated in this single-arm interventional trial. Participants were oriented to a non-clinical model representing a 15 kg toddler, which incorporated a 22-gauge IV catheter. Following a standardization procedure, participants administered 600 mL (40 mL/kg) of saline to the simulated child under emergency conditions using prefilled 60-mL syringes. Each participant completed 5 testing trials. All testing was video recorded, with fluid administration time outcome data (in seconds) extracted from trial videos by two blinded outcome assessors. Data describing catheter dislodgement events, volume of saline effectively delivered, and participant demographics were also collected. The primary outcome of fluid administration time test-retest reliability was analyzed by one-way analysis of variance (ANOVA) and intra-class correlation (ICC), with good reliability defined as ICC > 0.70.

Results

Differences in HCP fluid administration times are attributable to inter-subject variability rather than intra-subject variability based on one-way ANOVA analysis, F (14,60) = 43.125; p < 0.001. Test-retest reliability of subjects was excellent with ICC = 0.97 (95% CI: 0.95-0.99); p < 0.001.

Conclusions

Findings demonstrate excellent test-retest reliability of HCP fluid resuscitation performance in a setting involving a non-clinical model. Investigators can justify a single evaluation of HCP performance in future studies.

【 授权许可】

   
2014 Parker et al.; licensee BioMed Central Ltd.

【 图 表 】

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