Tofil Nancy M, Lin Yiqun, Zhong John, Peterson Dawn Taylor, White Marjorie Lee, Grant Vincent, Grant David J, Gottesman Ronald, Sudikoff Stephanie N, Adler Mark, Marohn Kimberly, Davidson Jennifer, Cheng Adam
1Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 2KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, Department of Pediatrics, University of Calgary, Calgary, AB, Canada. 3Department of Pediatrics, University of Texas Southwestern, Dallas, TX. 4Department of Pediatrics, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United Kingdom. 5Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, QC, Canada. 6Department of Pediatrics, Yale Medical School, New Haven, CT. 7Department of Pediatrics, Northwestern University School of Medicine, Chicago, IL 8Department of Pediatrics, Tufts University School of Medicine, Boston, MA.
Pediatr Crit Care Med. 2017 Sep;18(9):e423-e427. doi: 10.1097/PCC.0000000000001258.
Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members.
Multicenter observational study.
Nine pediatric simulation centers (five United States, three Canada, and one United Kingdom).
Team leaders and team members during a 12-minute pediatric sepsis scenario.
National Aeronautics and Space Administration-Task Load Index.
One hundred twenty-seven teams were recruited from nine sites. One hundred twenty-seven team leaders and 253 team members completed the National Aeronautics and Space Administration-Task Load Index. Team leader had significantly higher overall workload than team member (51 ± 11 vs 44 ± 13; p < 0.01). Team leader had higher workloads in all subcategories except in performance where the values were equal and in physical demand where team members were higher than team leaders (29 ± 22 vs 18 ± 16; p < 0.01). The highest category for each group was mental 73 ± 13 for team leader and 60 ± 20 for team member. For team leader, two categories, mental (73 ± 17) and effort (66 ± 16), were high workload, most domains for team member were moderate workload levels.
Team leader and team member are under moderate workloads during a pediatric sepsis scenario with team leader under high workloads (> 60) in the mental demand and effort subscales. Team leader average significantly higher workloads. Consideration of decreasing team leader responsibilities may improve team workload distribution.
危机资源管理原则规定了精神和/或体力工作量的合理分配，以免使任何一名团队成员不堪重负。儿科急诊期间的工作量尚未得到充分研究。美国国家航空航天局任务负荷指数是一种多维度工具，旨在评估在多种环境中得到验证的工作量。低工作量定义为低于40，中等工作量为40 - 60，大于60表示高工作量。我们的假设是，在模拟儿科脓毒症场景中，团队领导和团队成员的工作量为中等至高，且团队领导的工作量高于团队成员。
多中心观察性研究。
九个儿科模拟中心（五个在美国，三个在加拿大，一个在英国）。
在12分钟儿科脓毒症场景中的团队领导和团队成员。
美国国家航空航天局任务负荷指数。
从九个地点招募了127个团队。127名团队领导和253名团队成员完成了美国国家航空航天局任务负荷指数。团队领导的总体工作量显著高于团队成员（51±11 vs 44±13；p<0.01）。除了在表现方面两者数值相等以及在体力需求方面团队成员高于团队领导（29±22 vs 18±16；p<0.01）外，团队领导在所有子类别中的工作量都更高。每组最高的类别是精神方面，团队领导为73±13，团队成员为60±20。对于团队领导，精神（73±17）和努力（66±16）这两个类别为高工作量，团队成员的大多数领域为中等工作量水平。
在儿科脓毒症场景中，团队领导和团队成员处于中等工作量，团队领导在精神需求和努力子量表方面处于高工作量（>60）。团队领导的平均工作量显著更高。考虑减少团队领导的职责可能会改善团队工作量分配。
