Fischer Paul, Abendschein Robin, Berberich Monika, Grundgeiger Tobias, Meybohm Patrick, Smul Thorsten, Happel Oliver
University Hospital Würzburg, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Oberdürrbacher Straße 6, 97080 Würzburg, Germany.
Julius-Maximilians-Universität Würzburg, Institute Human-Computer-Media, Oswald-Külpe-Weg 82, 97074 Würzburg, Germany.
Resusc Plus. 2024 Apr 3;18:100612. doi: 10.1016/j.resplu.2024.100612. eCollection 2024 Jun.
Handovers during medical emergencies are challenging due to time-critical, dynamic and oftentimes unorderly and distracting situations. We evaluated the effect of distraction-reduced clinical surroundings during handover on (1) the recall of handover information, (2) the recall of information from the surroundings and (3) self-reported workload in a simulated in-hospital cardiac arrest scenario.
In a parallel group design, emergency team leaders were randomly assigned to receive a structured handover of a cardio-pulmonary resuscitation (CPR) either inside the room ("inside group") right next to the ongoing CPR or in front of the room ("outside group") with no audio-visual distractions from the ongoing CPR. Based on the concept of situation awareness, the primary outcome was a handover score for the content of the handover (0-19 points) derived from the pieces of information given during handover. Furthermore, we assessed team leaders' perception of their surroundings during the scenario (0-5 points) and they rated their subjective workload using the NASA Task Load Index.
The outside group ( = 30) showed significant better recall of handover information than the inside group ( = 30; mean difference = 1.86, 95% CI = 0.67 to 3.06, = 0.003). The perception of the surroundings ( = 60; mean difference = -0.27, 95% CI = -0.85 to 0.32, = 0.365) and the NASA Task Load Index ( = 58; mean difference = 1.1; = 0.112) did not differ between the groups.
Concerning in-hospital emergencies, a structured handover in a distraction reduced environment can improve information uptake of the team leader.
在医疗紧急情况下进行交接班具有挑战性，因为情况紧急、动态变化，而且往往杂乱无章且干扰因素众多。我们评估了在模拟的院内心脏骤停场景中，交接班期间减少干扰的临床环境对（1）交接班信息的回忆、（2）周围环境信息的回忆以及（3）自我报告的工作量的影响。
采用平行组设计，将急诊团队负责人随机分配至在正在进行心肺复苏（CPR）的房间内（“室内组”）紧挨着正在进行的CPR接受结构化的心肺复苏交接班，或在房间外（“室外组”）接受交接班，这样正在进行的CPR不会产生视听干扰。基于态势感知的概念，主要结局是根据交接班期间提供的信息得出的关于交接班内容的评分（0 - 19分）。此外，我们评估了场景中团队负责人对周围环境的感知（0 - 5分），并使用美国国家航空航天局任务负荷指数对他们的主观工作量进行评分。
室外组（n = 30）在交接班信息的回忆方面显著优于室内组（n = 30；平均差异 = 1.86，95%CI = 0.67至3.06，P = 0.003）。两组之间在周围环境感知方面（n = 60；平均差异 = -0.27，95%CI = -0.85至0.32，P = 0.365）以及美国国家航空航天局任务负荷指数方面（n = 58；平均差异 = 1.1；P = 0.112）没有差异。
对于院内紧急情况，在减少干扰的环境中进行结构化交接班可提高团队负责人对信息的接收能力。
