Abstract
BackgroundWhen working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes.MethodTwenty interprofessional teams from the northern part of Sweden participated in this randomized controlled intervention study conducted in situ in two intensive care units. The study was based on three cases (cases 0, 1 and 2) with patients in a critical situation. The intervention group (n = 11) participated in a two-hour educational programme in situation awareness, including theory, practice, and reflection, while the control group (n = 9) performed the training without education in situation awareness. The outcomes were team performance (TEAM instrument), task performance (ABCDE checklist) and situation awareness (Situation Awareness Global Assessment Technique (SAGAT)). Generalized estimating equation were used to analyse the changes from case 0 to case 2, and from case 1 to case 2.ResultsEducation in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group. No significant differences were observed in the SAGAT or the ABCDE checklist.ConclusionsThis intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate that the one or several of the components in situation awareness (perception, comprehension and projection) were improved. However, in the present study this potential increase in situation awareness was not detected with SAGAT. Further research is needed to evaluate how educational programs can be used to increase situation awareness in interprofessional ICU teams and to establish which components that are essential in these programs.Trial registrationThis randomized controlled trial was not registered as it does not report the results of health outcomes after a health care intervention on human participants.
Highlights
Preventable adverse events are common in intensive care units (ICU), both in Sweden [1] and globally [2]
Education in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group
This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation
Summary
Preventable adverse events are common in intensive care units (ICU), both in Sweden [1] and globally [2]. Several studies have reported shortcomings in intensive care teamwork in respect to team leadership [4] and patient outcomes [5]. Fewer studies have focused on ICU teams’ situation awareness (SA) in order to improve team and task performance [6]. It is clear that teamwork in the ICU depends on individuals’ coordinated actions and understanding of tasks, including collective cognitive structures such as shared mental models to optimize care [10]. When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes
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