Jonsson Karin, Brulin Christine, Härgestam Maria, Lindkvist Marie, Hultin Magnus
Department of Nursing and Department of Surgical and Perioperative Sciences, Anesthesiology and Critical Care Medicine, Umeå University, S-901 87, Umeå, Sweden.
Department of Nursing, Umeå University, S-901 87, Umeå, Sweden.
Scand J Trauma Resusc Emerg Med. 2021 Jun 2;29(1):73. doi: 10.1186/s13049-021-00878-2.
When working in complex environments with critically ill patients, team performance is influenced by situation awareness in teams. Moreover, improved situation awareness in the teams will probably improve team and task performance. The aim of this study is to evaluate an educational programme on situation awareness for interprofessional teams at the intensive care units using team and task performance as outcomes.
Twenty interprofessional teams from the northern part of Sweden participated in this randomized controlled intervention study conducted in situ in two intensive care units. The study was based on three cases (cases 0, 1 and 2) with patients in a critical situation. The intervention group (n = 11) participated in a two-hour educational programme in situation awareness, including theory, practice, and reflection, while the control group (n = 9) performed the training without education in situation awareness. The outcomes were team performance (TEAM instrument), task performance (ABCDE checklist) and situation awareness (Situation Awareness Global Assessment Technique (SAGAT)). Generalized estimating equation were used to analyse the changes from case 0 to case 2, and from case 1 to case 2.
Education in situation awareness in the intervention group improved TEAM leadership (p = 0.003), TEAM task management (p = 0.018) and TEAM total (p = 0.030) when comparing cases 1 and 2; these significant improvements were not found in the control group. No significant differences were observed in the SAGAT or the ABCDE checklist.
This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate that the one or several of the components in situation awareness (perception, comprehension and projection) were improved. However, in the present study this potential increase in situation awareness was not detected with SAGAT. Further research is needed to evaluate how educational programs can be used to increase situation awareness in interprofessional ICU teams and to establish which components that are essential in these programs.
This randomized controlled trial was not registered as it does not report the results of health outcomes after a health care intervention on human participants.
在重症患者所处的复杂环境中工作时，团队绩效会受到团队态势感知的影响。此外，团队态势感知的提升可能会改善团队和任务绩效。本研究旨在以团队和任务绩效为结果，评估一项针对重症监护病房跨专业团队的态势感知教育项目。
来自瑞典北部的20个跨专业团队参与了这项在两个重症监护病房现场进行的随机对照干预研究。该研究基于三个处于危急状况患者的病例（病例0、1和2）。干预组（n = 11）参加了为期两小时的态势感知教育项目，包括理论、实践和反思，而对照组（n = 9）进行了没有态势感知教育的培训。结果指标包括团队绩效（TEAM工具）、任务绩效（ABCDE清单）和态势感知（态势感知全局评估技术（SAGAT））。使用广义估计方程分析从病例0到病例2以及从病例1到病例2的变化。
与病例1和病例2相比，干预组的态势感知教育改善了TEAM领导力（p = 0.003）、TEAM任务管理（p = 0.018）和TEAM总分（p = 0.030）；对照组未发现这些显著改善。在SAGAT或ABCDE清单中未观察到显著差异。
这项干预研究表明，两小时的态势感知教育改善了急性护理情况下团队绩效的部分方面。干预组的团队领导力和任务管理得到改善，这可能表明态势感知的一个或多个组成部分（感知、理解和预测）得到了改善。然而，在本研究中，SAGAT未检测到态势感知的这种潜在提升。需要进一步研究以评估如何利用教育项目提高跨专业重症监护病房团队的态势感知，并确定这些项目中哪些组成部分至关重要。
本随机对照试验未进行注册，因为它未报告对人类参与者进行医疗保健干预后的健康结果。
