Shah Palak, Havalad Vinod
Pediatric Critical Care Medicine, Presbyterian Hospital - The Children's Center at Presbyterian, Albuquerque, NM.
Pediatric Simulation Program, Pediatric Critical Care Medicine, Advocate Children's Hospital, Advocate Aurora Health, Park Ridge, IL.
J Patient Cent Res Rev. 2021 Oct 18;8(4):354-359. doi: 10.17294/2330-0698.1847. eCollection 2021 Fall.
Prompt and clear code team leader identification is vital in effective cardiopulmonary resuscitation (CPR), and pediatric trainees often have limited experience in these scenarios. This project sought to develop a tangible object that provided clear leader identification and assisted in code team management and simulated team training. A Code Team Leader Card (CTLC) was designed to provide clear leader identification while simultaneously providing a cognitive aid via integration of pediatric advanced life support (PALS) algorithms. Additionally, CTLC served to occupy the leader's hands to limit their ability to intervene on procedural tasks. The CTLC was incorporated into pediatric resident simulation training, and pre- and postintervention survey data were analyzed. Analysis particularly focused on whether "a leader was clearly identified by all team members." The relationship between CTLC implementation and consistent leader recognition was evaluated using chi-squared test, and secondary qualitative data were obtained via debriefing sessions. Pediatric residents completed 131 surveys prior to CTLC implementation and 41 surveys after implementation. Consistent code team leader recognition increased significantly from 61.8% (81 of 131) pre-CTLC to 80.5% (33 of 41) after introduction of CTLC (P=0.027). Participants commented on the benefits of CTLC during debriefing sessions. Use of a CTLC significantly improved leader recognition during simulated CPR. Inclusion of PALS algorithms led to normalization and increased utilization of these adjunct materials. The CTLC provided a secondary benefit of occupying the leader's hands, thereby allowing that person to focus on overseeing the team rather than assisting with procedural tasks.
迅速且明确地识别代码团队负责人对有效的心肺复苏 (CPR) 至关重要，而儿科实习生在这些场景中的经验往往有限。本项目旨在开发一种实体物品，以提供明确的负责人识别，并协助代码团队管理和模拟团队培训。设计了代码团队负责人卡片 (CTLC)，以提供明确的负责人识别，同时通过整合儿科高级生命支持 (PALS) 算法提供认知辅助。此外，CTLC 用于占据负责人的双手，以限制他们对程序任务进行干预的能力。CTLC 被纳入儿科住院医师模拟培训，并对干预前后的调查数据进行了分析。分析特别关注 “所有团队成员是否都能清楚地识别出负责人”。使用卡方检验评估 CTLC 实施与一致的负责人识别之间的关系，并通过汇报会获得二级定性数据。儿科住院医师在 CTLC 实施前完成了 131 份调查问卷，实施后完成了 41 份调查问卷。代码团队负责人的一致识别率从 CTLC 实施前的 61.8%（131 人中的 81 人）显著提高到引入 CTLC 后的 80.5%（41 人中的 33 人）（P = 0.027）。参与者在汇报会上对 CTLC 的益处发表了评论。在模拟心肺复苏期间，使用 CTLC 显著提高了负责人的识别率。纳入 PALS 算法导致这些辅助材料的标准化和利用率提高。CTLC 还有一个额外的好处，即占据负责人的双手，从而使该人能够专注于监督团队，而不是协助程序任务。
