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未来的重症监护团队协作:TeamSTEPPS 在 COVID-19 大流行中的作用及对未来的启示

Critical Care Teamwork in the Future: The Role of TeamSTEPPS in the COVID-19 Pandemic and Implications for the Future.

作者信息

Terregino Carol A, Jagpal Sugeet, Parikh Payal, Pradhan Archana, Weber Paul, Michaels Lauren, Nicastro Olivia, Escobar Jared, Rashid Hanin

机构信息

Rutgers Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA.

Robert Wood Johnson Barnabas Health, New Brunswick, NJ 08901, USA.

出版信息

Healthcare (Basel). 2023 Feb 17;11(4):599. doi: 10.3390/healthcare11040599.

Abstract

At our institution, we observed inconsistency in the application of structural facilitators for interprofessional teamwork such as handoffs and communication of contingency planning, complete formation and engagement of teams on interprofessional rounds, regular situation monitoring, interprofessional huddles, use of "check back" during code situations, and standard debriefings after codes and procedures (TeamSTEPPS). To enhance team performance, we piloted TeamSTEPPS training and reinforcement for all healthcare team members in the medical intensive care unit (MICU), inclusive of trainees, advanced practice providers (APPs), nurses, and respiratory therapists rotating through the unit. Seven months after the training launch, the initial COVID-19 surge interrupted the reinforcement stage of the pilot providing an opportunity to study the retention of TeamSTEPPS principles and its potential role in response to a crisis. We conducted interprofessional focus groups after a year of crisis management during the pandemic. Themes revealed how TeamSTEPPS training impacted teamwork and communication, as well as factors that influenced the use of TeamSTEPPS. This work points to the value of team training in unexpected scenarios. Additional studies at multiple sites are needed to determine scalability for all MICU teams or for onboarding new team members.

摘要

在我们机构,我们观察到在应用跨专业团队合作的结构性促进因素时存在不一致的情况,例如交接班和应急计划的沟通、跨专业查房时团队的完整组建和参与、定期的情况监测、跨专业碰头会、在急救情况下使用“复述确认”以及急救和操作后的标准汇报(团队策略与工具)。为了提高团队绩效,我们在医疗重症监护病房(MICU)对所有医疗团队成员(包括实习医生、高级实践提供者、护士和轮转至该病房的呼吸治疗师)开展了团队策略与工具培训及强化培训。培训启动七个月后,最初的新冠疫情激增打断了试点的强化阶段,这为研究团队策略与工具原则的保留情况及其在应对危机中的潜在作用提供了契机。在疫情期间进行了一年的危机管理后,我们开展了跨专业焦点小组讨论。讨论主题揭示了团队策略与工具培训如何影响团队合作和沟通,以及影响团队策略与工具使用的因素。这项工作表明了团队培训在意外情况下的价值。需要在多个地点开展更多研究,以确定所有MICU团队或新入职团队成员推广该培训的可行性。

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本文引用的文献

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Interprofessional communication in healthcare: An integrative review.医疗保健中的跨专业沟通:一项综合综述。
Nurse Educ Pract. 2016 Jul;19:36-40. doi: 10.1016/j.nepr.2016.04.005. Epub 2016 May 3.

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