JMIR Publications

ABSTRACT

Background:

Mobile apps are increasingly used in various domains of medicine. Few are evidence-based and their benefits can only be achieved if end-users intend to adopt and use them. To date, only a small fraction of mobile apps have published data on their field usability and end-user acceptance results, especially in emergency medicine.

Objective:

This study aims to determine the usability and acceptance of an evidence-based mobile app while safely preparing emergency drugs at the point-of-care during pediatric in- and out-of-hospital cardiopulmonary resuscitations by frontline caregivers.

Methods:

In two multicenter, randomized, controlled parent trials conducted at six pediatric emergency departments from March 1 to December 31, 2017, and 14 emergency medical services from September 3, 2019, to January 21, 2020, the usability and technology acceptance of the PedAMINES (Pediatric Accurate Medication in Emergency Situations) app were evaluated among skilled pediatric emergency nurses and advanced paramedics when preparing continuous infusions of vasoactive drugs and direct intravenous emergency drugs at pediatric dosages during standardized, simulation-based, pediatric in- and out-of-hospital cardiac-arrest scenarios, respectively. Usability was measured by the 10-item System Usability Scale (SUS). A 26-item technology acceptance self-administered survey (5-point Likert-type scales) adapted from the Unified Theory of Acceptance and Use of Technology model was used to measure app acceptance and intention to use.

Results:

One hundred and twenty-eight nurses of 128 (crossover trial) and 74 paramedics of 150 (parallel trial) were assigned to the mobile app. Mean total scores on the SUS were excellent and reached 89.5 (SD 8.8 [95% CI 88.0-91.1]) for nurses and 89.7 (SD 8.7 [95% CI 87.7-91.7]) for paramedics. Acceptance of the technology was very good and rated on average >4.5 out of 5 for five of the eight independent constructs evaluated. Only the image construct scored between 3.2 and 3.5 by both participant populations.

Conclusions:

The results provide evidence that dedicated mobile apps can be easy to use and highly accepted at the point-of-care during in- and out-of-hospital cardiopulmonary resuscitations by frontline emergency caregivers. These findings can contribute to the implementation and valorization of studies aiming to evaluate the usability and acceptance of mobile apps in the field by caregivers, even in critical situations. Clinical Trial: ClinicalTrials.gov NCT03021122; https://clinicaltrials.gov/ct2/show/ NCT03021122, and ClinicalTrials.gov NCT03921346; https://clinicaltrials.gov/ct2/show/NCT03921346