Azimirad Mina, Magnusson Carin, Wiseman Allison, Selander Tuomas, Parviainen Ilkka, Turunen Hannele
Department of Nursing Science, University of Eastern Finland (UEF), Kuopio, Finland.
Duke of Kent Building, School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Surrey, UK.
Nurs Crit Care. 2022 Nov;27(6):804-814. doi: 10.1111/nicc.12676. Epub 2021 Jul 3.
The role of medical emergency team (MET) in managing deteriorating patients and enhancing patient safety is greatly affected by teamwork.
To identify teamwork-related needs of the MET from MET nurses' perspectives. To assess the associations between MET nurses' perceptions of teamwork and their work experience and education.
A quantitative, descriptive correlational design.
Registered intensive care unit (ICU) nurses (n = 50) who were members of the MET in an acute tertiary care hospital answered a modified version of the team assessment questionnaire in 2017. Data were analysed using descriptive statistics, the Kruskal-Wallis test, and the univariate analysis of variance method. The reporting of this study adheres to the strengthening the reporting of observational studies (STROBE) guidelines.
Participants showed least agreement with the items presenting leadership skills (mean = 2.6, SD = 0.68). Approximately 50% nurses disagreed that the MET had adequate resources, training, and skills. The majority of nurses (80%) felt that their responsibilities as a MET member interfered with taking care of their own ICU patients. Many nurses (64%) felt that they did not have a voice in MET's decision-making process. Approximately 50% nurses felt that they were not recognized for their individual contribution, and they were uncertain regarding MET's policies for dealing with conflicts. The amounts of MET nurses' work experience and education were associated with MET skills and function, respectively.
Key teamwork elements of the MET that need improvements include decision-making and conflict resolution skills, valuing team members, and team leadership. Practicing shared mental models, implementing the TeamSTEPPS curricula at hospitals for training ICU nurses, and simulation-based team-training programmes may be beneficial in improving teamwork of MET members.
This study revealed key teamwork elements of the MET that need improvements. Our findings may contribute to improve teamwork, thereby optimizing MET function, and enhancing patient outcomes.
医疗急救团队（MET）在管理病情恶化患者及提高患者安全方面的作用受到团队协作的极大影响。
从MET护士的角度确定MET与团队协作相关的需求。评估MET护士对团队协作的认知与其工作经验和教育程度之间的关联。
定量、描述性相关性设计。
2017年，一家急性三级护理医院中作为MET成员的注册重症监护病房（ICU）护士（n = 50）回答了一份经过修改的团队评估问卷。使用描述性统计、Kruskal-Wallis检验和单因素方差分析方法对数据进行分析。本研究的报告遵循加强观察性研究报告（STROBE）指南。
参与者对呈现领导技能的项目的认同度最低（均值 = 2.6，标准差 = 0.68）。约50%的护士不同意MET拥有足够的资源、培训和技能。大多数护士（80%）认为他们作为MET成员的职责妨碍了对自己ICU患者的护理。许多护士（64%）觉得他们在MET的决策过程中没有发言权。约50%的护士觉得他们的个人贡献未得到认可，并且他们对MET处理冲突的政策不确定。MET护士的工作经验量和教育程度分别与MET技能和功能相关。
MET需要改进的关键团队协作要素包括决策和解决冲突的技能、重视团队成员以及团队领导能力。实践共享心智模型、在医院实施TeamSTEPPS课程以培训ICU护士以及基于模拟的团队培训项目可能有助于改善MET成员的团队协作。
本研究揭示了MET需要改进的关键团队协作要素。我们的研究结果可能有助于改善团队协作，从而优化MET功能并提高患者治疗效果。
