Leadership factors for cardiopulmonary resuscitation for clinicians in-hospital; behaviours, skills and strategies: A systematic review and synthesis without meta-analysis.

Abstract

To identify leadership factors for clinicians during in-hospital cardiopulmonary resuscitation. Systematic review with synthesis without meta-analysis. The review was guided by SWiM, assessed for quality using CASP and reported with PRISMA. Cochrane, EMBASE, PubMed, Medline, Scopus and CINAHL (years of 2013-2023) and a manual reference list search of all included studies. A total of 60 papers were identified with three major themes of useful resuscitation leadership; 'social skills', 'cognitive skills and behaviour' and 'leadership development skills' were identified. Main factors included delegating effectively, while being situationally aware of team members' ability and progress during resuscitation, and being empathetic and supportive, yet 'controlling the room' using a hands-off style. Shared decision-making to reduce cognitive load for one leader was shown to improve effective teamwork. Findings were limited by heterogeneity of studies and inconsistently applied tools to measure leadership. Traditional authoritarian leadership styles are not wanted by team members with preference for shared leadership and collaboration. Balancing this with the need for team members to see leaders in 'control of the room' brings new challenges for leaders and trainers of resuscitation. All clinicians need effective leadership skills for cardiopulmonary resuscitation in-hospital. Nurses provide first response and ongoing leadership for cardiopulmonary resuscitation. Nurses typically display suitable skills that align with useful resuscitation leader factors. What were the main findings? Collaboration rather than an authoritarian approach to leadership is preferred by team members. Nurses are suitable to 'control the room'. Restricting resuscitation team size will manage disruptive behaviour of team members. PROSPERO Registration: CRD42022385630. No patient of public contribution.