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other·hematology, critical care, surgery, research methods, clinical trial·PMC10044818

User Perceptions of ROTEM-Guided Haemostatic Resuscitation: A Mixed Qualitative–Quantitative Study

Bioengineering · 12 authors, 2 centres

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TL;DR

This mixed-methods study explored anaesthetists' perceptions of ROTEM for guiding haemostatic resuscitation. The central finding was that users value its accuracy and rapid results but find result interpretation cognitively demanding, especially in emergencies.

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801 CHARS

This mixed qualitative–quantitative study investigated anaesthetists' perceptions of rotational thromboelastometry (ROTEM)-guided haemostatic resuscitation. The research involved interviews with clinicians followed by an online survey. The main results indicate that users perceive the accuracy of ROTEM, provided by numerical data and temograms, as its most important positive feature, along with its real-time monitoring and rapid availability of results. However, the primary criticism was the significant cognitive resources required to interpret results, which is challenging in emergencies and for inexperienced users. Limitations include the potential for interview bias due to prior exposure to a comparison technology and the single-centre, European context, which may limit generalizability.

STUDY TYPE

other

SPECIALTY

hematology

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100% · A

ORIGINAL PAPER

PMC10044818

User Perceptions of ROTEM-Guided Haemostatic Resuscitation: A Mixed Qualitative–Quantitative Study

Bioengineering

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ABSTRACT

Abstract Viscoelastic point-of-care haemostatic resuscitation methods, such as ROTEM or TEG, are crucial in deciding on time-efficient personalised coagulation interventions. International transfusion guidelines emphasise increased patient safety and reduced treatment costs. We analysed care providers’ perceptions of ROTEM to identify perceived strengths and areas for improvement. We conducted a single-centre, mixed qualitative–quantitative study consisting of interviews followed by an online survey. Using a template approach, we first identified themes in the responses given by care providers about ROTEM. Later, the participants rated six statements based on the identified themes on five-point Likert scales in an online questionnaire. Seventy-seven participants were interviewed, and 52 completed the online survey. By analysing user perceptions, we identified ten themes. The most common positive theme was “high accuracy”. The most common negative theme was “need for training”. In the online survey, 94% of participants agreed that monitoring the real-time ROTEM temograms helps to initiate targeted treatment more quickly and 81% agreed that recurrent ROTEM training would be beneficial. Anaesthesia care providers found ROTEM to be accurate and quickly available to support decision-making in dynamic and complex haemostatic situations. However, clinicians identified that interpreting ROTEM is a complex and cognitively demanding task that requires significant training needs. Keywords: haemostasis, coagulation management, point-of-care, viscoelastic test, rotational thromboelastometry, user-centred design, situation awareness

CITATION EXPORT

Greta Gasciauskaite, Amos Malorgio, Clara Castellucci et al.. User Perceptions of ROTEM-Guided Haemostatic Resuscitation: A Mixed Qualitative–Quantitative Study. Bioengineering. (2023). https://doi.org/10.3390/bioengineering10030386

AUTHORS

12 · 2 CENTRES

Greta Gasciauskaite, Amos Malorgio, Clara Castellucci, Alexandra Budowski, Giovanna Schweiger, Michaela Kolbe, Bastian Grande, Christoph B Noethiger, Donat R Spahn, Tadzio R Roche, David W Tscholl, Samira Akbas

1Institute of Anaesthesiology, University Hospital Zurich, Frauenklinikstrasse 10, 8091 Zurich, Switzerland
2Simulation Center, University Hospital Zurich, Gloriastrasse 19, 8091 Zurich, Switzerland