Clinical Safety Research Unit, Department of Surgery & Cancer, Imperial College London, 10th Floor QEQM Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
Resuscitation. 2012 Nov;83(11):1374-80. doi: 10.1016/j.resuscitation.2012.06.026. Epub 2012 Jul 11.
Inadequately designed equipment has been implicated in poor efficiency and critical incidents associated with resuscitation. A novel resuscitation trolley (Resus:Station) was designed and evaluated for impact on team efficiency, user opinion, and teamwork, compared with the standard trolley, in simulated cardiac arrest scenarios.
Fifteen experienced cardiac arrest teams were recruited (45 participants). Teams performed recorded resuscitation simulations using new and conventional trolleys, with order of use randomised. After each simulation, efficiency ("time to drugs", un-locatable equipment, unnecessary drawer opening) and team performance (OSCAR) were assessed from the video recordings and participants were asked to complete questionnaires scoring various aspects of the trolley on a Likert scale.
Time to locate the drugs was significantly faster (p=0.001) when using the Resus:Station (mean 5.19s (SD 3.34)) than when using the standard trolley (26.81s (SD16.05)). There were no reports of missing equipment when using the Resus:Station. However, during four of the fifteen study sessions using the standard trolley participants were unable to find equipment, with an average of 6.75 unnecessary drawer openings per simulation. User feedback results clearly indicated a highly significant preference for the newly designed Resus:Station for all aspects. Teams performed equally well for all dimensions of team performance using both trolleys, despite it being their first exposure to the Resus:Station.
We conclude that in this simulated environment, the new design of trolley is safe to use, and has the potential to improve efficiency at a resuscitation attempt.
设计不当的设备可能会导致复苏效率低下和出现危及生命的差错事件。我们设计了一种新型复苏车(Resus:Station),并在模拟心搏骤停场景中对其与标准复苏车相比对团队效率、用户意见和团队协作的影响进行了评估。
招募了 15 支经验丰富的心脏骤停团队(45 名参与者)。各团队使用新的和传统的复苏车进行记录的复苏模拟,使用顺序随机化。每次模拟后,从视频记录中评估效率(“用药时间”、无法定位的设备、不必要的抽屉打开)和团队表现(OSCAR),并要求参与者使用李克特量表对推车的各个方面进行评分,以评估对推车的各个方面的意见。
使用 Resus:Station 定位药物的时间明显更快(p=0.001)(平均 5.19s(SD 3.34)),而使用标准推车的时间为 26.81s(SD16.05)。使用 Resus:Station 时没有报告设备缺失的情况。然而,在使用标准推车的 15 次研究会议中,有四次参与者无法找到设备,每次模拟平均有 6.75 个不必要的抽屉打开。用户反馈结果清楚地表明,对于所有方面,新设计的 Resus:Station 都受到高度青睐。尽管团队是第一次接触 Resus:Station,但使用两种推车时,团队在团队表现的所有方面都表现出色。
我们的结论是,在这种模拟环境下,新设计的推车安全易用,并且有可能提高复苏尝试的效率。