The mandatory educational module increases the effect of implementing the standard operating procedure and adherence to the lung-protective ventilation concept during anaesthesia
Bibliographic record
Abstract
BACKGROUND AND GOALS OF THE STUDY: Adherence to lung-protective ventilation leads to a lower incidence of perioperative pulmonary complications. However, adherence is reported to be only approximately 15% worldwide. Therefore, we conducted a prospective interventional clinical pre-post study to assess the impact of a standardized operating procedure (SOP) enhanced with a mandatory educational programme on adherence to intraoperative lung protective ventilation (IOLPV). MATERIALS AND METHODS: First, we assessed the current level of adherence to the IOLPV concept (Group A - before SOP). Thereafter, we implemented the SOP enhanced with a mandatory educational programme. When the program finished, our team assessed the new adherence level to the LPV concept (Group B - after SOP). We compared the number of cases that abided by each IOLPV recommendation and the number of cases that abided by the whole IOLPV bundle between the groups. RESULTS: A total of 164 patients were enrolled (Group A 82, Group B 82) in the study. The number of procedures with adherence to the whole IOLPV bundle was significantly greater in Group B (Group A, 4%; Group B, 24%; p < 0.001). Similarly, the total number of recruitment manoeuvres performed was significantly greater in Group B than in Group A (Group A 11, Group B 35, p < 0.001). The mean positive end-expiratory pressure (PEEP) was likewise significantly greater in Group B than in Group A (Group A, 6.6 ± 1.88 mbar; Group B, 7.8 ± 2.10 mbar; p < 0.001), leading to significantly more cases with an abiding level of PEEP, as recommended in Group B, than in Group A (Group A, 22; Group B, 49; p < 0.001). There was no significant difference between the groups in terms of the number of cases that abided by the plateau, the driving pressure, the tidal volume, or the breathing frequency. CONCLUSIONS: The SOP enhanced with a mandatory educational program focused on IOLPV may be an effective tool for increasing adherence to IOLPV in daily practice. TRIAL REGISTRATION: The study has been preregistered in registry clinicaltrials.gov and assigned the study registration number NCT05831683 with the brief title "Standard Operating Procedure as a Valuable Tool to Increase Adherence to Lung Protective Ventilation among Anaesthesiologists". Initial release on 3.4.2023 accessible on link https://clinicaltrials.gov/study/NCT05831683 .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".