Who's Who in the PACU? Role Designation During Emergencies

Abstract

<h3>Introduction</h3> There is ample evidence that high performance teams are vital to patient survival during emergency events. Role designation among clinicians is key for high-performing emergency response teams. <h3>Identification of the problem</h3> Poor team dynamics and communication breakdown is often the cause of preventable errors with patient mortality/morbidity occurring more often when team dynamics fail. Lack of role designation may lead to adverse patient outcomes during emergency events. <h3>EBP Question/Purpose</h3> Does role designation strategy impact PACU staff team dynamics during emergency situations? <i>Databases/Resources Utilized</i>: CINHAL PubMed UpToDate ASPAN 2021 Scope and Standards AHA 2020 Pediatric Advanced Life Support Guidelines finding 12 articles and selecting <i>Mayo High Performance Teamwork Scale.</i> Synthesized findings support role designation as an effective strategy for high performing emergency response teams and simulation as a learning tool to improve knowledge confidence and clinical skills. <i>Purpose</i>: Implement and evaluate the effectiveness of an evidence-based role designation strategy for PACU staff during emergency situations with aims to improve staff confidence staff knowledge and team dynamics. <h3>Methods/Evidence</h3> <i>Pre-intervention</i>: Survey distributed to PACU staff to assess knowledge of emergency skill/concepts with 5-point Likert scale measuring confidence of role assumption and skills needed for each role. Team dynamics evaluated using the validated <i>Mayo High Performance Teamwork Scale</i> during unit mock codes. <i>Intervention</i>: Education via skill stations for the following roles/concepts: Effective Team Dynamics Airway Management Crash Cart Compressions & Documentation. Roles and Designation Tool implemented during education. <i>Post-intervention</i>: Repeated survey of knowledge and confidence with staff. Comparative team dynamics evaluated with <i>Mayo High Performance Teamwork Scale</i> during unit mock codes. <h3>Significance of Findings/Outcomes</h3> Implementation of an evidence-based Role Designation Tool with education improved role delineation among PACU staff. Consistency in understanding assumed role during emergencies improved from 0% role-consistency (0/10 simulated events) to 87.5% role-consistency (7/8 simulated events) (p < 0.001). <h3>Implications for perianesthesia nurses and future research</h3> Implementation of a role designation tool in the PACU provides PACU staff with a clear plan for emergencies. This clear plan improves communication team dynamics and comfort among PACU staff during emergencies positively impacting patient outcomes.