Team communication patterns in emergency resuscitation: a mixed methods qualitative analysis

被引：26

作者：

Calder L.A. ^{[1
,3
,5
]}

Mastoras G. ^{[1
]}

Rahimpour M. ^{[4
]}

Sohmer B. ^{[2
]}

Weitzman B. ^{[1
]}

Cwinn A.A. ^{[1
]}

Hobin T. ^{[4
]}

Parush A. ^{[4
]}

机构：

[1] Department of Emergency Medicine, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, E-Main, Room EM-206, Box 227, Ottawa, K1Y 4E9, ON

[2] Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, K1Y 4W7, ON

[3] Clinical Epidemiology Program, Ottawa Hospital Research Institute, 1053 Carling Avenue, Room F6-58, Ottawa, K1Y 4E9, ON

[4] Department of Psychology, Carleton University, Loeb B550, 1125 Colonel By Drive, Ottawa, K1S 5B6, ON

[5] Department of Emergency Medicine, University of Ottawa, 1053 Carling Avenue, E-Main, Room EM-206, Box 227, Ottawa, K1Y 4E9, ON

来源：

International Journal of Emergency Medicine | 2017年 / 10卷 / 1期

关键词：

Cardiac arrest; Communication; Emergency department; Resuscitation; Situational awareness; Teams; Trauma;

D O I：

10.1186/s12245-017-0149-4

中图分类号：

学科分类号：

摘要：

Background: In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team’s relationships) and information needs. Methods: We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations. We interviewed 18 resuscitation team members about shared mental models, roles and goals of team members and procedural expectations. We observed 30 simulated resuscitation video recordings and documented the timing, source and destination of communication and the information category. We observed 12 live resuscitations in the emergency department and recorded baseline characteristics of the type of resuscitations, nature of teams present and type and content of information exchanges. The data were analyzed using a qualitative communication analysis method. Results: We found that resuscitation team members described a shared mental model. Respondents understood the roles and goals of each team member in order to provide rapid, efficient and life-saving care with an overall need for situational awareness. The information flow described in the interviews was reflected during the simulated and live resuscitations with the most responsible physician and charting nurse being central to team communication. We consolidated communicated information into six categories: (1) time; (2) patient status; (3) patient history; (4) interventions; (5) assistance and consultations; 6) team members present. Conclusions: Resuscitation team members expressed a shared mental model and prioritized situational awareness. Our findings support a need for cognitive aids to enhance team communication during resuscitations. © 2017, The Author(s).

引用

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