Improving patient's intensive care admission through multidisciplinary simulation-based crisis resource management: A qualitative study

被引:3
作者
Jensen, Janet F. F. [1 ,2 ,3 ]
Ramos, Joanna [2 ,4 ]
Orom, Marie-Louise [2 ]
Naver, Kirsten B. B. [2 ]
Shiv, Louise [2 ]
Bunkenborg, Gitte [3 ,5 ,6 ]
Kodal, Anne Marie [2 ]
Skram, Ulrik [2 ]
机构
[1] Zealand Univ Hosp, Dept Neurol, Roskilde, Denmark
[2] Univ Copenhagen, North Zealand Hosp, Dept Anesthesiol, Copenhagen, Denmark
[3] Univ Southern Denmark, Dept Reg Hlth Res, Odense, Denmark
[4] Rigshosp, Dept Thorac Anaesthesiol, Copenhagen, Denmark
[5] Zealand Univ Hosp, Dept Cardiol, Roskilde, Denmark
[6] Holbaek Cent Hosp, Dept Anesthesiol, Holbaek, Denmark
关键词
advanced practice; health care quality; intensive care; multiprofessional education; qualitative study; quality improvement; research implementation; simulation; HEALTH-CARE; NONTECHNICAL SKILLS; OPERATING-THEATER; SAFETY; TEAMWORK; HANDOVER; NURSES; UNIT;
D O I
10.1111/jocn.16821
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
AimTo explore nurses' and physicians' experiences of simulation-based training in a crisis resource management quality improvement intervention on intensive care admission. BackgroundQuantitative studies have documented that staffs' non-technical skills are improved after simulation-based training in crisis resource management interventions. Experienced-based consensus led to development of a quality improvement intervention based on principles of crisis resource management and tested in simulation-based training to enhance staffs' non-technical skills. However, the impact on staff is unexplored, leaving little understanding of the relationship between simulation-based training in crisis resource management interventions and changes in non-technical skills. DesignA qualitative study with a hermeneutical approach. MethodsData consisted of semi-structured interviews with physicians (n = 5) and nurses (n = 15) with maximum variation in work experience. Data were collected 3 months after implementation and analysed using thematic analysis. The COREQ guideline was applied. ResultsThe analysis revealed three themes: prioritising core clinical activities and patient centredness; transition into practice; and reflection on patient safety. These themes reflected staff's experiences of the intervention and implementation process, which evolved through prioritising core clinical activities that facilitated the transition into clinical practice and staff's reflection on patient safety. ConclusionsPrioritising core clinical activities were facilitated by clear communication, predefined roles and better teamwork. Transition into practice stimulated professional growth through feedback. Reflection on patient safety created a new understanding on how a new structure of intensive care admission could be implemented. Collectively, this indicated a joint understanding of admissions. Implications for PracticeFindings enables health care professionals to understand how the intervention can contribute to improve quality of care in management of intensive care admission. Improving non-technical skills are vital in high-quality admissions, which supported a structured process and a collaborative professional standard of admissions. Patient and Public ContributionNone.
引用
收藏
页码:7530 / 7542
页数:13
相关论文
共 49 条
  • [11] Fleming Valerie, 2003, Nurs Inq, V10, P113, DOI 10.1046/j.1440-1800.2003.00163.x
  • [12] Anaesthetists' non-technical skills
    Flin, R.
    Patey, R.
    Glavin, R.
    Maran, N.
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 2010, 105 (01) : 38 - 44
  • [13] Gadamer H.-G., 1975, TRUTH METHOD 3
  • [14] Gadamer Hans-Georg., 2006, Truth and Method
  • [15] Debriefing after simulation-based non-technical skill training in healthcare: a systematic review of effective practice
    Garden, A. L.
    Le Fevre, D. M.
    Waddington, H. L.
    Weller, J. M.
    [J]. ANAESTHESIA AND INTENSIVE CARE, 2015, 43 (03) : 300 - 308
  • [16] Guba E.G., 2005, SAGE HDB QUALITATIVE, P191
  • [17] Team competence among nurses in an intensive care unit: The feasibility of in situ simulation and assessing non-technical skills
    Gundrosen, Stine
    Solligard, Erik
    Aadahl, Petter
    [J]. INTENSIVE AND CRITICAL CARE NURSING, 2014, 30 (06) : 312 - 317
  • [18] Crew resource management in the ICU: the need for culture change
    Haerkens, Marck H. T. M.
    Jenkins, Donald H.
    van der Hoeven, Johannes G.
    [J]. ANNALS OF INTENSIVE CARE, 2012, 2
  • [19] Enabling Continuous Quality Improvement in Practice: The Role and Contribution of Facilitation
    Harvey, Gillian
    Lynch, Elizabeth
    [J]. FRONTIERS IN PUBLIC HEALTH, 2017, 5
  • [20] Crew resource management training in the intensive care unit. A multisite controlled before-after study
    Kemper, Peter F.
    de Bruijne, Martine
    van Dyck, Cathy
    So, Ralph L.
    Tangkau, Peter
    Wagner, Cordula
    [J]. BMJ QUALITY & SAFETY, 2016, 25 (08) : 577 - 587