Onwochei Desire N, Halpern Stephen, Balki Mrinalini
From the Department of Anesthesia (D.O., M.B.) and Pain Management, Mount Sinai Hospital; and Department of Anesthesia (S.H.), Sunnybrook Health Centre, University of Toronto, Toronto, Ontario, Canada.
Simul Healthc. 2017 Jun;12(3):165-176. doi: 10.1097/SIH.0000000000000210.
Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies.
We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data.
Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity.
More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.
基于团队的培训和模拟可以通过改善团队成员之间的沟通、决策和表现来提高患者安全。目前,对于是否有特定的评估工具更适合评估产科紧急情况中的团队协作,尚无普遍共识。本定性系统评价的目的是找出可用于评估产科紧急情况中团队效能的工具。
我们检索了Embase、Medline、PubMed、Web of Science、PsycINFO、CINAHL和谷歌学术,以查找评估涉及产科紧急情况的多学科团队非技术技能的前瞻性研究。检索范围包括1944年至2016年1月11日的研究。收集了关于可靠性和有效性测量的数据并用于解释。对数据进行了描述性分析。
最终的定性综合分析纳入了13项研究。所有研究均在产科模拟场景中评估团队,但只有6项研究在模拟中纳入了麻醉师。一项研究仅使用有效性测量来评估其团队协作工具,五项仅使用可靠性测量,一项同时使用了两者。确定的最可靠工具为临床团队协作量表、产科团队绩效整体评估和绩效整体评分量表。然而,它们在质量和有效性方面仍存在不足。
需要开展更多工作来确定用于评估非技术技能的团队协作工具的有效性,开发理想工具是有必要的。还需要进一步研究来评估使用这些工具时,诸如表现和患者安全等结果会受到怎样的影响。