Heart of England NHS Foundation Trust, Birmingham, United Kingdom.
Crit Care Med. 2012 Sep;40(9):2617-21. doi: 10.1097/CCM.0b013e3182591fda.
This study aims to explore the relationship between team-leadership skills and quality of cardiopulmonary resuscitation in an adult cardiac-arrest simulation. Factors affecting team-leadership skills were also assessed.
Forty advanced life-support providers leading a cardiac arrest team in a standardized cardiac-arrest simulation were videotaped. Background data were collected, including age (in yrs), sex, whether they had received any leadership training in the past, whether they were part of a professional group, the most recent advanced life-support course (in months) they had undergone, advanced life-support instructor/provider status, and whether they had led in any cardiac arrest situation in the preceding 6 months.
Participants were scored using the Cardiac Arrest Simulation test score and Leadership Behavior Description Questionnaire for leadership skills. Process-focused quality of cardiopulmonary resuscitation data were collected directly from manikin and video recordings. Primary outcomes were complex technical skills (measured as Cardiac Arrest Simulation test score, preshock pause, and hands-off ratio). Secondary outcomes were simple technical skills (chest-compression rate, depth, and ventilation rate). Univariate linear regressions were performed to examine how leadership skills affect quality of cardiopulmonary resuscitation and bivariate correlations elicited factors affecting team-leadership skills.Teams led by leaders with the best leadership skills performed higher quality cardiopulmonary resuscitation with better technical performance (R = 0.75, p < .001), shorter preshock pauses (R = 0.18, p < .001), with lower total hands-off ratio (R = 0.24, p = .01), and shorter time to first shock (R = 0.14, p = .02). Leadership skills were not significantly associated with more simple technical skills such as chest-compression rate, depth, and ventilation rate. Prior training in team leader skills was independently associated with better leadership behavior.
There is an association between team leadership skills and cardiac arrest simulation test score, preshock pause, and hands off ratio. Developing leadership skills should be considered an integral part of resuscitation training.
本研究旨在探讨团队领导技能与成人心脏骤停模拟心肺复苏质量之间的关系，并评估影响团队领导技能的因素。
对 40 名在标准化心脏骤停模拟中领导心脏骤停团队的高级生命支持提供者进行录像。收集背景数据，包括年龄（岁）、性别、过去是否接受过任何领导力培训、是否属于专业团队、最近接受的高级生命支持课程（月）、高级生命支持指导员/提供者身份以及在过去 6 个月内是否领导过任何心脏骤停情况。
使用心脏骤停模拟测试评分和领导力行为描述问卷对参与者进行评分，以评估领导技能。心肺复苏过程质量数据直接从模拟人和录像中收集。主要结果是复杂技术技能（以心脏骤停模拟测试评分、电击前暂停和脱手比衡量）。次要结果是简单技术技能（胸外按压率、深度和通气率）。进行单变量线性回归以检查领导技能如何影响心肺复苏质量，并进行双变量相关分析以确定影响团队领导技能的因素。领导技能最佳的团队进行的心肺复苏质量更高，技术表现更好（R = 0.75，p <.001），电击前暂停时间更短（R = 0.18，p <.001），总脱手比更低（R = 0.24，p =.01），首次电击时间更短（R = 0.14，p =.02）。领导技能与胸外按压率、深度和通气率等简单技术技能没有显著相关性。团队领导技能的先前培训与更好的领导行为独立相关。
团队领导技能与心脏骤停模拟测试评分、电击前暂停和脱手比之间存在关联。应该将领导技能的培养视为复苏培训的一个组成部分。
