Abstract
BackgroundVideo analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50 % of cases. Multidisciplinary simulation is used as a first-rate tool for the improvement of teamwork among health professionals. In the study we evaluated the impact of the crisis resource management (CRM) and anesthesia non-technical skills instruction on teamwork during simulated newborn emergencies.MethodsNinety-nine participants of two delivery units (17 pediatricians, 16 anesthesiologists, 14 obstetricians, 31 midwives, and 21 neonatal nurses) were divided to an intervention group (I-group, 9 teams) and a control group (C-group, 6 teams). The I-group attended a CRM and ANTS instruction before the first scenario. After each scenario the I-group performed either self- or peer-assessment depending on whether they had acted or observed in the scenario. All the teams participated in two and observed another two scenarios. All the scenarios were video-recorded and scored by three experts with Team Emergency Assessment Measure (TEAM). SPSS software and nlme package were used for the statistical analyses.ResultsThe total TEAM scores of the first scenario between the I- and C-group did not differ from each other. Neither there was an increase in the TEAM scoring between the first and second scenario between the groups. The CRM instruction did not improve the I-group’s teamwork performance. Unfortunately the teams were not comparable because the teams had been allowed to self-select their members in the study design. The total TEAM scores varied a lot between the teams. Mixed-model linear regression revealed that the background of the team leader had an impact on differences of the total teamwork scores (D = 6.50, p = 0.039). When an anesthesia consultant was the team leader the mean teamwork improved by 6.41 points in comparison to specialists of other disciplines (p = 0.043).ConclusionThe instruction of non-technical skills before simulation training did not enhance the acquisition of teamwork skills of the intervention groups over the corresponding set of skills of the control groups. The teams led by an anesthesiologist scored the best. Experience of team leaders improved teamwork over the CRM instruction.
Highlights
Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50 % of cases
The principal aim of this study was to compare the Team Emergency Assessment Measure (TEAM) scores in response to simulations between a control group (C-group) and an intervention group (I-group) that both participated in two subsequent scenarios of simulated newborn emergencies in real emergency rooms of two delivery units
In the comparison of the groups there were significantly (p < 0.05) more participants in the I-group whose working experience was less than 1 year
Summary
Video analyses of real-life newborn resuscitations have shown that Neonatal Resuscitation Program (NRP) guidelines are followed in fewer than 50 % of cases. Video analyses of real-life newborn resuscitations have shown. Simulation-based training is the standard method of teaching neonatal resuscitation [4]. Intubation, and cardiac compression can be taught and rehearsed separately using high-fidelity newborn mannequins [6, 7], teaching co-ordinated teamwork to heterogeneous groups of medical specialists in an intensive emergency setting is a much greater challenge. The Joint Commission on Accreditation of Healthcare Organizations in the United States has recommended that team training should be taught to medical staff members to improve effective communication and cooperation during critical events [8]. A recent review article indicated that simulations, videos, and didactic lectures are effective methods of teaching teamwork [9]
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