Cant Robyn P, Porter Joanne E, Cooper Simon J, Roberts Kate, Wilson Ian, Gartside Christopher
School of Nursing and Midwifery, Monash University, Narre Warren, Victoria, Australia.
School of Nursing, Midwifery and Healthcare, Federation University Australia, Churchill, Victoria, Australia.
Emerg Med Australas. 2016 Dec;28(6):641-646. doi: 10.1111/1742-6723.12643. Epub 2016 Jul 28.
This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes.
Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes.
In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement.
Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool.
本前瞻性描述性研究旨在检验团队应急评估量表（TEAM™）评估现实世界中医疗应急团队非技术技能的有效性和可行性。其次，本研究旨在探讨该工具在团队协作和学习成果方面对实践的贡献。
澳大利亚维多利亚州农村地区两家医院急诊科的注册护士（RN）和医务人员（n = 104）参与了研究。在10个月的时间里，多名临床医生在医疗紧急事件中完成了（TEAM™）量表。
在80次现实世界中的医疗应急团队复苏事件（283次临床医生评估）中，非技术技能评分平均每次事件为89%（满分44分中的39分）。21次事件被评为最低四分位数（即44分中≤37分）。评分因学科而异，医生评分者给出的分数（平均：41.1±4.4）显著高于注册护士（38.7±5.4）（P = 0.001）。这种差异出现在领导领域。该工具具有可靠性，Cronbach's alpha为0.78，具有较高的单维度效度，平均项目间相关性为0.45。TEAM™得分与授予的总体评分之间的强相关性（P < 0.001）证实了同时效度，共享方差为38.4%。注册护士称赞该工具，因为它引发了员工围绕绩效改进的反思和汇报讨论。
已知医疗应急团队的非技术技能往往不理想；然而，在这项现实世界研究中平均评分达到了89%。TEAM™是一种有效、可靠且易于使用的工具，适用于培训和临床环境，用作评估和/或汇报工具时对团队绩效有益。
