CRM u zbrinjavanju kritično obolelog pacijenta - da li sestra može biti kopilot?

Abstract

Crew Resource Management, Cocpit Resource Management - CRM is a set of a training procedures used in environments where human error can cause fatal consequences. It is used to improve security of the aircraft and focuses on interpersonal communication, leadership and decision-making in the cockpit. Today, CRM is applicable in all fields where critical decisions are being made: air traffic control, ship handling, firefighting, as well as in medicine where CRM is being practiced for operating room staff and all emergency services. After 20 years of its successful usage for the airline personnel, the healthcare system became interested in CRM when the US Institute of Medicine specifically suggested use of this model, to improve patients safety and reduce the risk of mishaps. Despite the significant efforts to improve safety through the promotion of teamwork, there was no scientifically validated tool for measuring teamwork in the health care services. The paper will present published studies about teamwork and application of CRM in the healthcare system. It will also present methods and techniques on how the teamwork is valued and efficiency of training which actively joins all members of the healthcare team (briefings, checklists and communication techniques that can foster an environment of mutual respect ). For these purposes, the patented 'black box' is a digital system used for recording and archiving all data related to operating procedures and working environment including screening and monitoring, which is followed by complete analysis of all collected data. It also provides an opportunity for implementing studies on operating outturn, potential intraoperative errors, teamwork output and communication. The conclusion of the conducted studies is that there are distinctions in the perception of teamwork in operating room, considering doctors and nurses standpoint. Excellent individuals, although highly skilled in their discipline, may not perform well in teams and therefore can not be useful team members, even though they are often hierarchically set as leaders. Therefore, the training by CRM methodology would enable the acquisition of important communication skills of these individuals and, also, encourage other team members to communicate among each other using nonconflict tools.