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A randomized trial comparing two intraosseous access devices in intrahospital healthcare providers with a focus on retention of knowledge, skill, and self-efficacy

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Intraosseous access is recommended in vitally compromised patients if an intravenous access cannot be easily obtained. Intraosseous infusion can be initiated by various healthcare providers. Currently, there are two mechanical intraosseous devices approved by the U.S. Food and Drug Administration (FDA) for use in adults and children. A comparison is made in this study of the theoretical and practical performance by anesthesiologists and registered nurses of anesthesia (RNAs) in the use of the battery-powered device (device A) versus the spring-loaded needle device (device B). This study entailed a 12-month follow-up of knowledge, skill retention, and self-efficacy measured by standardized testing.

Methods

A prospective randomized trial was performed, initially comparing 15 anesthesiologists and 15 RNAs, both on using the two types of intraosseous devices. A structured lecture and skill station was given with the educational aids provided by the respective manufacturers. Individual knowledge and practical skills were tested at 0, 3, and 12 months after the initial course.

Results

There was no statistical significant difference in the retention of theoretical knowledge between RNAs and anesthesiologists on all testing occasions. However, the self-efficacy of the anesthesiologists is significantly higher (p < 0.01) than the self-efficacy of the RNAs for both devices, on any testing occasion. Insufficient skills were local disinfection (both groups, both devices) and attachment of the needle to the intravenous line (RNAs with both devices). In 33 % of all device B handlings, unsafe practice occurred.

Conclusion

The use of device A is safer in handling in comparison to device B at 12 months follow-up. The hypothesis that doctors are more qualified in obtaining intraosseous access has been disproven, as anesthesiologists were as successful as RNAs. However, the low self-efficacy of RNAs in the use of intraosseous devices could diminish the chance of them actually using one.

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Conflict of interest

Hendrik Derikx, Bastiaan Gerritse, Renate Gans, and Nardo van der Meer declare that, for none of the authors, is there any conflict of interest in any sense. No grant for this study was received and no support was provided by the manufacturers of the devices involved.

Compliance with Ethics Guidelines

This article does not contain any studies with human or animal subjects performed by any of the authors. Anonymity of participants was guaranteed and the ethical review board was notified of this study.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    H. J. G. M. Derikx

  2. Department of Cardiac Anesthesiology and Intensive Care, Amphia Hospital Breda and Oosterhout, Molengracht 21, 4818 CK, Breda, The Netherlands

    B. M. Gerritse, R. Gans & N. J. M. van der Meer

Authors
  1. H. J. G. M. Derikx
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  2. B. M. Gerritse
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  3. R. Gans
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  4. N. J. M. van der Meer
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Corresponding author

Correspondence to B. M. Gerritse.

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Derikx, H.J.G.M., Gerritse, B.M., Gans, R. et al. A randomized trial comparing two intraosseous access devices in intrahospital healthcare providers with a focus on retention of knowledge, skill, and self-efficacy. Eur J Trauma Emerg Surg 40, 581–586 (2014). https://doi.org/10.1007/s00068-014-0385-8

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  • DOI: https://doi.org/10.1007/s00068-014-0385-8

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