Abstract
BackgroundEffective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual’s technical skills and too little on the teams’ performance of non-technical skills. The aim of the study was to explore intensive care nurses’ team performance in a simulation-based emergency situation by using expert raters’ assessments and nurses’ self-assessments in relation to different intensive care specialties.MethodsThe study used an explorative design based on laboratory high-fidelity simulation. Fifty-three registered nurses, who were allocated into 11 teams representing two intensive care specialties, participated in a videotaped simulation-based cardiac arrest setting. The expert raters used the Ottawa Crisis Resource Management Global Rating Scale and the first part of the Mayo High Performance Teamwork Scale to assess the teams’ performance. The registered nurses used the first part of the Mayo High Performance Teamwork Scale for their self-assessments, and the analyses used were Chi-square tests, Mann–Whitney U tests, Spearman’s rho and Intraclass Correlation Coefficient Type III.ResultsThe expert raters assessed the teams’ performance as either advanced novice or competent, with significant differences being found between the teams from different specialties. Significant differences were found between the expert raters’ assessments and the registered nurses’ self-assessments.ConclusionsTeams of registered nurses representing specialties with coronary patients exhibit a higher competence in non-technical skills compared to team performance regarding a simulated cardiac arrest. The use of expert raters’ assessments and registered nurses’ self-assessments are useful in raising awareness of team performance with regard to patient safety.Electronic supplementary materialThe online version of this article (doi:10.1186/s12912-014-0047-5) contains supplementary material, which is available to authorized users.
Highlights
Effective teamwork has proven to be crucial for providing safe care
The principles for training teams to cope with stressful situations and error management were developed by the airline industry [18] and transferred to health care by Gaba et al [19], who adapted the use of human patient simulators into the crisis resource management (CRM) programme
In relation to scenario roles, significant differences were found with regard to the helper role in “age” (χ2 (2) = 7.71, p = .013) and in “years as PGRNs” (χ2 (2) =7.81, p = .008), with helpers in teams representing general intensive care units (G-intensive care unit (ICU)) with a higher age and longer experience as PG-Registered nurse (RN)
Summary
Effective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual’s technical skills and too little on the teams’ performance of non-technical skills. According to Flin et al [10], teamwork consists of a number of elements such as supporting others, solving conflicts, exchanging information and coordinating activities, with one of the approaches used to minimize the effect of human error being to assist health-care teams in team performance training [11] by increasing individuals’ and teams’ competencies in non-technical skills (NTS) [12,13]. According to Flin et al [14], NTS generally include situational awareness, decision-making, communication, teamwork, leadership and the management of stress and fatigue. The principles for training teams to cope with stressful situations and error management were developed by the airline industry [18] and transferred to health care by Gaba et al [19], who adapted the use of human patient simulators into the CRM programme. With regard to CRM programmes, NTS are often termed as CRM skills [20,21]
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