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医疗服务提供者对急诊科复苏情境意识显示器的认知:一项模拟定性研究。

Healthcare providers' perceptions of a situational awareness display for emergency department resuscitation: a simulation qualitative study.

作者信息

Calder Lisa A, Bhandari Abhi, Mastoras George, Day Kathleen, Momtahan Kathryn, Falconer Matthew, Weitzman Brian, Sohmer Benjamin, Cwinn A Adam, Hamstra Stanley J, Parush Avi

机构信息

Department of Emergency Medicine, University of Ottawa, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.

Ottawa Hospital Research Institute, Clinical Epidemiology Program, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.

出版信息

Int J Qual Health Care. 2018 Feb 1;30(1):16-22. doi: 10.1093/intqhc/mzx159.

Abstract

IMPORTANCE

Emergency resuscitation of critically ill patients can challenge team communication and situational awareness. Tools facilitating team performance may enhance patient safety.

OBJECTIVES

To determine resuscitation team members' perceptions of the Situational Awareness Display's utility.

DESIGN

We conducted focus groups with healthcare providers during Situational Awareness Display development. After simulations assessing the display, we conducted debriefs with participants.

SETTING

Dual site tertiary care level 1 trauma centre in Ottawa, Canada.

PARTICIPANTS

We recruited by email physicians, nurses and respiratory therapist.

INTERVENTION

Situational Awareness Display, a visual cognitive aid that provides key clinical information to enhance resuscitation team communication and situational awareness.

MAIN OUTCOMES AND MEASURES

Themes emerging from focus groups and simulation debriefs. Three reviewers independently coded and analysed transcripts using content qualitative analysis.

RESULTS

We recruited a total of 33 participants in two focus groups (n = 20) and six simulation debriefs with three 4-5 member teams (n = 13). Majority of participants (10/13) strongly endorsed the Situational Awareness Display's utility in simulation (very or extremely useful). Focus groups and debrief themes included improved perception of patient data, comprehension of context and ability to project to future decisions. Participants described potentially positive and negative impacts on patient safety and positive impacts on provider performance and team communication. Participants expressed a need for easy data entry incorporated into clinical workflow and training on how to use the display.

CONCLUSION

Emergency resuscitation team participants felt the Situational Awareness Display has potential to improve provider performance, team communication and situational awareness, ultimately enhancing quality of care.

摘要

重要性

危重症患者的紧急复苏可能对团队沟通和态势感知构成挑战。有助于团队表现的工具可能会提高患者安全。

目的

确定复苏团队成员对态势感知显示器效用的看法。

设计

在态势感知显示器开发过程中,我们与医疗服务提供者进行了焦点小组讨论。在对显示器进行模拟评估后,我们与参与者进行了汇报总结。

地点

加拿大渥太华的双地点三级护理一级创伤中心。

参与者

我们通过电子邮件招募了医生、护士和呼吸治疗师。

干预措施

态势感知显示器,一种视觉认知辅助工具,可提供关键临床信息以增强复苏团队沟通和态势感知。

主要结局和衡量指标

焦点小组讨论和模拟汇报总结中出现的主题。三位评审员使用内容定性分析对记录进行独立编码和分析。

结果

我们在两个焦点小组(n = 20)和六个模拟汇报总结中总共招募了33名参与者,其中有三个4 - 5人团队(n = 13)。大多数参与者(10/13)强烈认可态势感知显示器在模拟中的效用(非常有用或极其有用)。焦点小组讨论和汇报总结的主题包括对患者数据的感知改善、情境理解以及对未来决策的预测能力。参与者描述了对患者安全可能产生的积极和消极影响以及对医疗服务提供者表现和团队沟通的积极影响。参与者表示需要将易于数据录入纳入临床工作流程,并需要关于如何使用该显示器的培训。

结论

紧急复苏团队参与者认为态势感知显示器有潜力改善医疗服务提供者表现、团队沟通和态势感知,最终提高护理质量。

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