Application and effectiveness evaluation of team resource management in emergency green track on acute cerebral stroke

Abstract

Objective To evaluate the effectiveness of applying team resource management (TRM) in emergency green track for acute ischemic stroke (AIS) patients treated by intravenous thrombolysis. Methods A historical control study was adopted in this study. During April to October in 2015, the experimental group consists of the acute ischemic stroke patients treated by intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA). Applying TRM in emergency green track to settle strategies, recreate procedures of it, and make use of TRM′s skills. Length of stay in emergency department (EDLOS), door to needle time (DNT), onset to treatment time (OTT). the percentage of DNT≤ 60 min, and emergency nurses′ total Safety Attitude Questionnaire (SAQ) score (Before vs. after) were evaluated between the two group patients. Results After applying TRM in the experimental group for the AIS patients, the median EDLOS was 54.88 min, the median DNT was 79.95 min, the median OTT was 173 min, and the percentage of DNT≤ 60 min was 23.7% (14/59), comparing with the control group which the median EDLOS was 80.33 min, the median DNT was 111.63 min, the median OTT was 243 min, and the percentage of DNT≤ 60 min was 9.8% (5/51); the two groups had significantly differences (Z=-6.141, -2.733, -4.691 , χ2=3.712, all P<0.05).The sore of emergency staff′s patient safety attitude increased significantly after applying TRM from 2.57 ± 0.35 to 3.39 ± 0.41(t=-3.704, P<0.05). Conclusions AIS patients′ EDLOS, DNT and OTT are significantly decreased after applying Team Resource Management, promoting staff′s SAQ-cores, patient safety as well as nursing quality. Key words: Team resource management; Green track, Length of stay; Door to needle time; Patient safety