Thomas E J, Taggart B, Crandell S, Lasky R E, Williams A L, Love L J, Sexton J B, Tyson J E, Helmreich R L
The University of Texas Center of Excellence for Patient Safety Research and Practice, Houston, TX 77030, USA.
J Perinatol. 2007 Jul;27(7):409-14. doi: 10.1038/sj.jp.7211771. Epub 2007 Jun 7.
To add a team training and human error curriculum to the Neonatal Resuscitation Program (NRP) and measure its effect on teamwork. We hypothesized that teams that received the new course would exhibit more teamwork behaviors than those in the standard NRP course.
Interns were randomized to receive NRP with team training or standard NRP, then video recorded when they performed simulated resuscitations at the end of the day-long course. Outcomes were assessed by observers blinded to study arm allocation and included the frequency or duration of six team behaviors: inquiry, information sharing, assertion, evaluation of plans, workload management and vigilance.
The interns in the NRP with team training group exhibited more frequent team behaviors (number of episodes per minute (95% CI)) than interns in the control group: information sharing 1.06 (0.24, 1.17) vs 0.13 (0.00, 0.43); inquiry 0.35 (0.11, 0.42) vs 0.09 (0.00, 0.10); assertion 1.80 (1.21, 2.25) vs 0.64 (0.26, 0.91); and any team behavior 3.34 (2.26, 4.11) vs 1.03 (0.48, 1.30) (P-values <0.008 for all comparisons). Vigilance and workload management were practiced throughout the entire simulated code by nearly all the teams in the NRP with team training group (100% for vigilance and 88% for workload management) vs only 53 and 20% of the teams in the standard NRP. No difference was detected in the frequency of evaluation of plans.
Compared with the standard NRP, NRP with a teamwork and human error curriculum led interns to exhibit more team behaviors during simulated resuscitations.
在新生儿复苏项目（NRP）中增加团队培训和人为失误课程，并评估其对团队协作的影响。我们假设接受新课程的团队比参加标准NRP课程的团队表现出更多的团队协作行为。
实习生被随机分配接受带有团队培训的NRP或标准NRP，然后在为期一天的课程结束时进行模拟复苏时进行视频记录。由对研究分组不知情的观察者评估结果，包括六种团队行为的频率或持续时间：询问、信息共享、断言、计划评估、工作量管理和警惕性。
接受团队培训的NRP组实习生比对照组实习生表现出更频繁的团队行为（每分钟事件数（95%置信区间））：信息共享1.06（0.24，1.17）对0.13（0.00，0.43）；询问0.35（0.11，0.42）对0.09（0.00，0.10）；断言1.80（1.21，2.25）对0.64（0.26，0.91）；以及任何团队行为3.34（2.26，4.11）对1.03（0.48，1.30）（所有比较的P值<0.008）。接受团队培训的NRP组几乎所有团队（警惕性为100%，工作量管理为88%）在整个模拟急救过程中都进行了警惕性和工作量管理，而标准NRP中只有53%和20%的团队进行了这些行为。在计划评估频率方面未检测到差异。
与标准NRP相比，带有团队协作和人为失误课程的NRP使实习生在模拟复苏过程中表现出更多的团队行为。
