在基于模拟的紧急情况下探索重症监护护士的团队表现，-专家评估与自我评估：一项探索性研究。
Exploring intensive care nurses' team performance in a simulation-based emergency situation, - expert raters' assessments versus self-assessments: an explorative study.
机构信息
Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, 651 88, Karlstad, Sweden ; Department of Nursing, Faculty of Health, Care and Nursing, Gjøvik University College, Teknologivn. 22, 2815 Gjøvik, Norway.
Department of Health Sciences, Faculty of Health, Science and Technology, Karlstad University, 651 88, Karlstad, Sweden.
出版信息
BMC Nurs. 2014 Dec 17;13(1):47. doi: 10.1186/s12912-014-0047-5. eCollection 2014.
BACKGROUND
Effective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual's technical skills and too little on the teams' performance of non-technical skills. The aim of the study was to explore intensive care nurses' team performance in a simulation-based emergency situation by using expert raters' assessments and nurses' self-assessments in relation to different intensive care specialties.
METHODS
The study used an explorative design based on laboratory high-fidelity simulation. Fifty-three registered nurses, who were allocated into 11 teams representing two intensive care specialties, participated in a videotaped simulation-based cardiac arrest setting. The expert raters used the Ottawa Crisis Resource Management Global Rating Scale and the first part of the Mayo High Performance Teamwork Scale to assess the teams' performance. The registered nurses used the first part of the Mayo High Performance Teamwork Scale for their self-assessments, and the analyses used were Chi-square tests, Mann-Whitney U tests, Spearman's rho and Intraclass Correlation Coefficient Type III.
RESULTS
The expert raters assessed the teams' performance as either advanced novice or competent, with significant differences being found between the teams from different specialties. Significant differences were found between the expert raters' assessments and the registered nurses' self-assessments.
CONCLUSIONS
Teams of registered nurses representing specialties with coronary patients exhibit a higher competence in non-technical skills compared to team performance regarding a simulated cardiac arrest. The use of expert raters' assessments and registered nurses' self-assessments are useful in raising awareness of team performance with regard to patient safety.
背景
有效的团队合作已被证明对提供安全护理至关重要。一般紧急情况的表现，尤其是心脏骤停情况的表现，主要侧重于个人的技术技能，而对团队的非技术技能表现关注太少，这一点受到了批评。本研究的目的是通过使用专家评估者的评估和护士对不同重症监护专业的自我评估，来探讨重症监护护士在基于模拟的紧急情况下的团队表现。
方法
该研究采用基于实验室高保真模拟的探索性设计。53 名注册护士被分配到代表两个重症监护专业的 11 个团队中，参与了一个基于录像的心脏骤停模拟场景。专家评估者使用渥太华危机资源管理全球评估量表和 Mayo 高绩效团队量表的第一部分来评估团队的表现。注册护士使用 Mayo 高绩效团队量表的第一部分进行自我评估，分析方法包括卡方检验、Mann-Whitney U 检验、Spearman rho 和 ICC 类型 III。
结果
专家评估者将团队的表现评估为高级新手或胜任，不同专业的团队之间存在显著差异。专家评估者的评估和注册护士的自我评估之间存在显著差异。
结论
与模拟心脏骤停相比，代表冠心病患者专业的注册护士团队在非技术技能方面表现出更高的能力。使用专家评估者的评估和注册护士的自我评估有助于提高对患者安全的团队表现的认识。
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