对手术团队在机组资源管理培训后遵守围手术期安全规范情况的观察性分析。
An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.
作者信息
France Daniel J, Leming-Lee Susie, Jackson Tom, Feistritzer Nancye R, Higgins Michael S
机构信息
Department of Anesthesiology, Vanderbilt University Medical Center, Medical Arts Building, Suite 732, Nashville, TN 37212-1212, USA.
出版信息
Am J Surg. 2008 Apr;195(4):546-53. doi: 10.1016/j.amjsurg.2007.04.012.
BACKGROUND
Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings.
METHODS
Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training.
RESULTS
Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program.
CONCLUSIONS
The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.
背景
鉴于医疗服务提供者之间需要改善团队沟通与协作，医疗保健管理人员和改进人员迅速认可并投资于航空机组资源管理（CRM）。尽管对CRM的兴趣日益浓厚，但关于CRM在临床环境中改变团队行为和绩效有效性的数据却很有限。
方法
对30个手术团队（15例神经外科手术病例和15例心脏手术病例）进行直接观察分析，以评估在广泛的CRM培训后手术团队对综合安全和CRM实践的遵守情况。
结果
观察到的手术团队仅遵守了培训计划中强调的60%的CRM和围手术期安全实践。
结论
结果凸显了医疗行业在努力将CRM从航空领域应用到医学领域时面临的诸多挑战。需要开展更多研究，以开发和测试针对临床团队的新的团队培训方法和绩效反馈机制。
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