Team training in the neonatal resuscitation program for interns: teamwork and quality of resuscitations
| Autor: | Robert E. Lasky, Amber L. Williams, Eric F. Reichman, William R. Taggart, Sharon S. Crandell, Eric J. Thomas |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Patient Care Team
Teamwork Resuscitation medicine.medical_specialty business.industry media_common.quotation_subject education MEDLINE Infant Newborn Internship and Residency law.invention Obstetrics and gynaecology Randomized controlled trial law Neonatal Resuscitation Program Pediatrics Perinatology and Child Health Physical therapy Medicine Humans Single-Blind Method business Curriculum Neonatal resuscitation media_common |
| Zdroj: | Pediatrics. 125(3) |
| ISSN: | 1098-4275 |
| Popis: | OBJECTIVE: Poor communication and teamwork may contribute to errors during neonatal resuscitation. Our objective was to evaluate whether interns who received a 2-hour teamwork training intervention with the Neonatal Resuscitation Program (NRP) demonstrated more teamwork and higher quality resuscitations than control subjects. METHODS: Participants were noncertified 2007 and 2008 incoming interns for pediatrics, combined pediatrics and internal medicine, family medicine, emergency medicine, and obstetrics and gynecology (n = 98). Pediatrics and combined pediatrics/internal medicine interns were eligible for 6-month follow-up (n = 34). A randomized trial was conducted in which half of the participants in the team training arm practiced NRP skills by using high-fidelity simulators; the remaining practiced with low-fidelity simulators, as did control subjects. Blinded, trained observers viewed video recordings of high-fidelity–simulated resuscitations for teamwork and resuscitation quality. RESULTS: High-fidelity training (HFT) group had higher teamwork frequency than did control subjects (12.8 vs 9.0 behaviors per minute; P < .001). Intervention groups maintained more workload management (control subjects: 89.3%; low-fidelity training [LFT] group: 98.0% [P < .001]; HFT group: 98.8%; HFT group versus control subjects [P < .001]) and completed resuscitations faster (control subjects: 10.6 minutes; LFT group: 8.6 minutes [P = .040]; HFT group: 7.4 minutes; HFT group versus control subjects [P < .001]). Overall, intervention teams completed the resuscitation an average of 2.6 minutes faster than did control subjects, a time reduction of 24% (95% confidence interval: 12%–37%). Intervention groups demonstrated more frequent teamwork during 6-month follow-up resuscitations (11.8 vs 10.0 behaviors per minute; P = .030). CONCLUSIONS: Trained participants exhibited more frequent teamwork behaviors (especially the HFT group) and better workload management and completed the resuscitation more quickly than did control subjects. The impact on team behaviors persisted for at least 6 months. Incorporating team training into the NRP curriculum is a feasible and effective way to teach interns teamwork skills. It also improves simulated resuscitation quality by shortening the duration. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|