Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France; TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France.
Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France; TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France.
Br J Anaesth. 2021 Apr;126(4):854-861. doi: 10.1016/j.bja.2020.12.011. Epub 2021 Jan 7.
Positive communication behaviour within anaesthesia teams may decrease stress response and improve clinical performance. We aimed to evaluate the effect of positive communication during medical handover on the subsequent team-based clinical performance in a simulated critical situation. We also assessed the effect of positive communication behaviour on stress response.
This single-centre RCT involved anaesthesia teams composed of a resident and a nurse in a high-fidelity scenario of anaesthesia-related paediatric laryngospasm after a standardised handover. During the handover, similar information was provided to all teams, but positive communication behaviour was adopted only for teams in the intervention group. Primary outcome was team-based clinical performance, assessed by an independent blinded observer, using video recordings and a 0-to 100-point scenario-specific scoring tool. Three categories of tasks were considered: safety checks before the incision, diagnosis/treatment of laryngospasm, and crisis resource management/non-technical skills. Individual stress response was monitored by perceived level of stress and HR variability.
The clinical performance of 64 anaesthesia professionals (grouped into 32 teams) was analysed. The mean (standard deviation) team-based performance score in the intervention group was 44 (10) points vs 35 (12) in the control group (difference: +8.4; CI [0.4-16.4]; P=0.04). The effects were homogeneous over the three categories of tasks. Perceived level of stress and HR variability were not significantly different between groups.
Positive communication behaviour between healthcare professionals during medical handover improved team-based performance in a simulation-based critical situation.
NCT03375073.
麻醉团队内部的积极沟通行为可能会降低应激反应，提高临床绩效。我们旨在评估在模拟危急情况下，医疗交接期间积极的沟通对随后的团队临床绩效的影响。我们还评估了积极沟通行为对应激反应的影响。
这项单中心 RCT 涉及由一名住院医师和一名护士组成的麻醉团队，他们在标准化交接后处于麻醉相关小儿喉痉挛的高保真模拟危急情况下。在交接期间，向所有团队提供相同的信息，但仅在干预组中采用积极的沟通行为。主要结果是使用视频记录和特定场景的 0 到 100 分评分工具，由独立的盲法观察员评估团队为基础的临床绩效。考虑了三个类别的任务：切口前的安全检查、喉痉挛的诊断/治疗和危机资源管理/非技术技能。个体应激反应通过感知到的压力水平和心率变异性进行监测。
分析了 64 名麻醉专业人员（分为 32 个团队）的临床绩效。干预组的平均（标准差）团队绩效评分为 44（10）分，对照组为 35（12）分（差异：+8.4；CI [0.4-16.4]；P=0.04）。三个类别的任务效果均具有同质性。组间感知压力水平和心率变异性无显著差异。
医疗交接期间医护人员之间的积极沟通行为改善了模拟危急情况下的团队临床绩效。
NCT03375073。
