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Developing a tool to assess competence in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): an international Delphi consensus study

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@article{f21f3e973def458285547b9cfeb1c45b,
title = "Developing a tool to assess competence in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): an international Delphi consensus study",
abstract = "BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure that is potentially lifesaving in major noncompressible torso hemorrhage. It may also improve outcome in nontraumatic cardiac arrest. However, the procedure can be technically challenging and requires the immediate presence of a qualified operator. Thus, evidence-based training and assessment of operator skills are essential for successful implementation and patient safety. A prerequisite for this is a valid and reliable assessment tool specific for the procedure. The aim of this study was to develop a tool for assessing procedural competence in REBOA based on best-available knowledge from international experts in the field.METHODS: We invited international REBOA experts from multiple specialties to participate in an anonymous three-round iterative Delphi study to reach consensus on the design and content of an assessment tool. In round 1, participants suggested items to be included. In rounds 2 and 3, the relevance of each suggested item was evaluated by all participants to reach consensus. Interround data processing was done systematically by a steering group.RESULTS: Forty panelists representing both clinical and educational expertise in REBOA from 16 countries (in Europe, Asia, and North and South America) and seven different specialties participated in the study. After 3 Delphi rounds and 532 initial item suggestions, the panelists reached consensus on a 10-item assessment tool with behaviorally anchored rating scales. It includes assessment of teamwork, procedure time, selection and preparation of equipment, puncture technique, guidewire handling, sheath handling, placement of REBOA catheter, occlusion, and evaluation.CONCLUSION: We present the REBOA-RATE assessment tool developed systematically by international experts in the field to optimize content validity. Following further studies of its validity and reliability, this tool represents an important next step in evidence-based training programs in REBOA, for example, using mastery learning.LEVEL OF EVIDENCE: Therapeutic, level V.",
keywords = "Assessment, Clinical competence, Delphi study, Expert consensus, Resuscitative endovascular balloon occlusion of the aorta, Skills",
author = "Morten Engberg and Tal H{\"o}rer and Rasmussen, {Todd E} and Mikkel Taudorf and Nayahangan, {Leizl Joy} and Rasmussen, {Niklas K} and Lene Russell and Lars Konge and Lars L{\"o}nn",
year = "2021",
doi = "10.1097/TA.0000000000003191",
language = "English",
volume = "91",
pages = "310--317",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams & Wilkins",
number = "2",

}

RIS

TY - JOUR

T1 - Developing a tool to assess competence in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

T2 - an international Delphi consensus study

AU - Engberg, Morten

AU - Hörer, Tal

AU - Rasmussen, Todd E

AU - Taudorf, Mikkel

AU - Nayahangan, Leizl Joy

AU - Rasmussen, Niklas K

AU - Russell, Lene

AU - Konge, Lars

AU - Lönn, Lars

PY - 2021

Y1 - 2021

N2 - BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure that is potentially lifesaving in major noncompressible torso hemorrhage. It may also improve outcome in nontraumatic cardiac arrest. However, the procedure can be technically challenging and requires the immediate presence of a qualified operator. Thus, evidence-based training and assessment of operator skills are essential for successful implementation and patient safety. A prerequisite for this is a valid and reliable assessment tool specific for the procedure. The aim of this study was to develop a tool for assessing procedural competence in REBOA based on best-available knowledge from international experts in the field.METHODS: We invited international REBOA experts from multiple specialties to participate in an anonymous three-round iterative Delphi study to reach consensus on the design and content of an assessment tool. In round 1, participants suggested items to be included. In rounds 2 and 3, the relevance of each suggested item was evaluated by all participants to reach consensus. Interround data processing was done systematically by a steering group.RESULTS: Forty panelists representing both clinical and educational expertise in REBOA from 16 countries (in Europe, Asia, and North and South America) and seven different specialties participated in the study. After 3 Delphi rounds and 532 initial item suggestions, the panelists reached consensus on a 10-item assessment tool with behaviorally anchored rating scales. It includes assessment of teamwork, procedure time, selection and preparation of equipment, puncture technique, guidewire handling, sheath handling, placement of REBOA catheter, occlusion, and evaluation.CONCLUSION: We present the REBOA-RATE assessment tool developed systematically by international experts in the field to optimize content validity. Following further studies of its validity and reliability, this tool represents an important next step in evidence-based training programs in REBOA, for example, using mastery learning.LEVEL OF EVIDENCE: Therapeutic, level V.

AB - BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure that is potentially lifesaving in major noncompressible torso hemorrhage. It may also improve outcome in nontraumatic cardiac arrest. However, the procedure can be technically challenging and requires the immediate presence of a qualified operator. Thus, evidence-based training and assessment of operator skills are essential for successful implementation and patient safety. A prerequisite for this is a valid and reliable assessment tool specific for the procedure. The aim of this study was to develop a tool for assessing procedural competence in REBOA based on best-available knowledge from international experts in the field.METHODS: We invited international REBOA experts from multiple specialties to participate in an anonymous three-round iterative Delphi study to reach consensus on the design and content of an assessment tool. In round 1, participants suggested items to be included. In rounds 2 and 3, the relevance of each suggested item was evaluated by all participants to reach consensus. Interround data processing was done systematically by a steering group.RESULTS: Forty panelists representing both clinical and educational expertise in REBOA from 16 countries (in Europe, Asia, and North and South America) and seven different specialties participated in the study. After 3 Delphi rounds and 532 initial item suggestions, the panelists reached consensus on a 10-item assessment tool with behaviorally anchored rating scales. It includes assessment of teamwork, procedure time, selection and preparation of equipment, puncture technique, guidewire handling, sheath handling, placement of REBOA catheter, occlusion, and evaluation.CONCLUSION: We present the REBOA-RATE assessment tool developed systematically by international experts in the field to optimize content validity. Following further studies of its validity and reliability, this tool represents an important next step in evidence-based training programs in REBOA, for example, using mastery learning.LEVEL OF EVIDENCE: Therapeutic, level V.

KW - Assessment

KW - Clinical competence

KW - Delphi study

KW - Expert consensus

KW - Resuscitative endovascular balloon occlusion of the aorta

KW - Skills

UR - http://www.scopus.com/inward/record.url?scp=85112329291&partnerID=8YFLogxK

U2 - 10.1097/TA.0000000000003191

DO - 10.1097/TA.0000000000003191

M3 - Journal article

C2 - 34259442

VL - 91

SP - 310

EP - 317

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 2

ER -

ID: 66793120