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Exploring intensive care nurses' team performance in a simulation-based emergency situation, − expert raters' assessments versus self-assessments: an explorative study
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Department of Nursing, Faculty of Health, Care and Nursing, Gjøvik University College, Teknologivn. 22, Gjøvik, 2815, Norway .
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.ORCID iD: 0000-0002-2667-4025
Department of Nursing, Faculty of Health, Care and Nursing, Gjövik Univeristy College, Norway.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Department of Nursing, Faculty of Health, Care and Nursing, Gjøvik University College, Teknologivn. 22, Gjøvik, 2815, Norway .ORCID iD: 0000-0003-3385-3731
2014 (English)In: BMC Nursing, ISSN 1472-6955, Vol. 13, no 47Article in journal (Refereed) Published
Abstract [en]

Background

Effective teamwork has proven to be crucial for providing safe care. The performance of emergencies in general and cardiac arrest situations in particular, has been criticized for primarily focusing on the individual's technical skills and too little on the teams' performance of non-technical skills. The aim of the study was to explore intensive care nurses' team performance in a simulation-based emergency situation by using expert raters' assessments and nurses' self-assessments in relation to different intensive care specialties.

Methods

The study used an explorative design based on laboratory high-fidelity simulation. Fifty-three registered nurses, who were allocated into 11 teams representing two intensive care specialties, participated in a videotaped simulation-based cardiac arrest setting. The expert raters used the Ottawa Crisis Resource Management Global Rating Scale and the first part of the Mayo High Performance Teamwork Scale to assess the teams' performance. The registered nurses used the first part of the Mayo High Performance Teamwork Scale for their self-assessments, and the analyses used were Chi-square tests, Mann–Whitney U tests, Spearman's rho and Intraclass Correlation Coefficient Type III.

Results

The expert raters assessed the teams' performance as either advanced novice or competent, with significant differences being found between the teams from different specialties. Significant differences were found between the expert raters' assessments and the registered nurses' self-assessments.

Conclusions

Teams of registered nurses representing specialties with coronary patients exhibit a higher competence in non-technical skills compared to team performance regarding a simulated cardiac arrest. The use of expert raters' assessments and registered nurses' self-assessments are useful in raising awareness of team performance with regard to patient safety.

Place, publisher, year, edition, pages
England: BioMed Central, 2014. Vol. 13, no 47
Keyword [en]
Assessment; Emergency; Intensive care; Non-technical skills; Nursing; Patient safety; Simulation-based training; Team performance
National Category
Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:kau:diva-29984DOI: 10.1186/s12912-014-0047-5PubMedID: 25606023OAI: oai:DiVA.org:kau-29984DiVA: diva2:663273
Note

This paper was publish as manuscript in R. Ballangruds thesis.

Available from: 2013-11-11 Created: 2013-11-11 Last updated: 2016-04-13Bibliographically approved
In thesis
1. Building patient safety in intensive care nursing: Patient safety culture, team performance and simulation-based training
Open this publication in new window or tab >>Building patient safety in intensive care nursing: Patient safety culture, team performance and simulation-based training
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing.

Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven ICUs and ten RNs from a post-graduate programme (II). The data were collected with questionnaires (II) and measurement scales (III), and analysed with statistics. In Study IV, 18 RNs were interviewed and the data were analysed with a qualitative content analysis.

Main findings: The RNs had positive perceptions of the overall patient safety culture in the ICUs. Hence, a potential for improvements was identified at both the unit and hospital level. Differences between types of ICUs and between hospitals were found. The dimensions at the unit level were predictors for the outcome dimensions (I). The RNs evaluated the simulation-based team training programme in a positive way. Differences with regard to scenario roles, prior simulation experience and area of intensive care practice were found (II). The expert raters assessed the teams’ performance as advanced novice or competent. There were differences between the expert raters’ assessments and the RNs’ self-assessments (III). One main category emerged to illuminate the RNs’ perceptions of simulation-based team training for building patient safety: Regular training increases the awareness of clinical practice and acknowledges the importance of structured work in teams (IV).

Conclusions: Patient safety culture measurements have the potential to identify areas in need of improvement, and simulation-based team training is appropriate to create a common understanding of structured work in teams with regard to patient safety.

Abstract [en]

Baksidestext

Intensive care represents potential patient safety challenges for critically ill patients. Human errors are the most common cause of incidents, and failures in team performance are identified as contributory factors. The measurements of patient safety culture and simulation-based team training are recommended initiatives to improve patient safety. The aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. The nurses had a positive perception of the overall patient safety culture. A potential for improvements were found in incident reporting, feedback and communication about errors and organizational learning. The RNs evaluated the simulation-based team training programme in a positive way. The assessments of nurses’ team performance with respect to communication, leadership and decision-making in a simulation-based emergency situation showed a variation in competencies from advanced novice to competent. There were differences between expert raters’ assessments and nurses’ self-assessments. The nurses perceived that simulation-based team training on a regular basis increases the awareness of clinical practice and acknowledges the importance of structured teamwork.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2013. 91 p.
Series
Karlstad University Studies, ISSN 1403-8099 ; 2013:46
Keyword
intensive care, nursing, patient safety, safety culture, simulation, team performance, team training
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:kau:diva-29870 (URN)978-91-7063-524-3 (ISBN)
Public defence
2013-12-06, Lagerlöfsalen, 1A 305, Karlstads universitet, Karlstad, 13:00 (Norwegian)
Opponent
Supervisors
Available from: 2013-11-08 Created: 2013-10-21 Last updated: 2013-11-14Bibliographically approved

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