Korean Journal of Adult Nursing (성인간호학회지)

Korean Society of Adult Nursing (한국성인간호학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship between Non-technical Skills and Resuscitation Performance of Nurses' Team in in-situ Simulated Cardiac Arrest

심정지 현장 시뮬레이션에서 일반 간호사의 비기술적 술기와 심폐소생술 수행 간의 관계

  • Kim, Eun Jung (Division of Nursing, Research Institute of Nursing Science, Hallym University) ;
  • Lee, Kyeong Ryong (Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine)
  • 김은정 (한림대학교 의과대학 간호학부) ;
  • 이경룡 (건국대학교 의학전문대학원 응급의학교실)
  • Received : 2014.11.20
  • Accepted : 2015.03.27
  • Published : 2015.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this descriptive study was to explore the relationship between non-technical skills (NTSs) and cardiopulmonary resuscitation (CPR) performance of nurses' teams in simulated cardiac arrest in the hospital. Methods: The sample was 28 teams of nurses in one university hospital located in Seoul. A high fidelity simulator was used to enact simulated cardiac arrest. The nurse teams were scored by raters using both the CPR performance checklist and the NTSs checklist. Specifically the CPR performance checklist included critical actions; time elapsed to initiation of critical actions, and quality of cardiac compression. The NTSs checklist was comprised of leadership, communication, mutual performance monitoring, maintenance of guideline, and task management. Data were collected directly from manikin and video recordings. Results: There was a significant difference between the medians of the NTSs and CPR performance (Mann Whitney U=43.5, p=.014). In five subcategories, communication (p=.026), mutual performance monitoring (p=.005), and maintenance of guideline (p=.003) differed significantly with CPR performance in medians. Leadership (p=.053) and task management (p=.080) were not significantly different with CPR performance. Conclusion: The findings indicate that NTSs of teams in addition to technical skills of individual rescuers affect the outcome of CPR. NTSs development and assessment should be considered an integral part of resuscitation training.

Keywords

References

  1. Marsch SC, Tschan F, Semmer N, Spychiger M, Breuer M, Hunziker PR. Performance of first responders in simulated cardiac arrests. Critical Care Medicine. 2005;33(5):963-7. http://dx.doi.org/10.1097/01.CCM.0000157750.43459.07
  2. Hunziker S, Johansson AC, Tschan F, Semmer NK, Rock L, Howell MD, et al. Teamwork and leadership in cardiopulmonary resuscitation. Journal of the American College of Cardiology. 2011;57(24):2381-8. http://dx.doi.org/10.1016/j.jacc.2011.03.017
  3. Abella BS, Alvarado JP, Myklebust H, Edelson DP, Barry A, O'Hearn N, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. The Journal of the American Medical Association. 2005;293(3):305-10. http://dx.doi.org/10.1001/jama.293.3.305
  4. Einav S, Shleifer A, Kark, JD, Landesberge G, Matot I. Performance of department staff in the window between discovery of collapse to cardiac arrest team arrival. Resuscitation. 2006;69(2):213-20. http://dx.doi.org/10.1016/j.resuscitation.2005.09.015
  5. Hunt EA, Walker AR, Shaffner DH, Miller MR, Pronovost, PJ. Simulation of in-hospital pediatric medical emergencies and cardiopulmonary arrests: highlighting the importance of the first 5 minutes. Pediatrics. 2008;121:e34-43. http://dx.doi.org/10.1542/peds.2007-0029
  6. Marsch SC, Muller C, Marquardt K, Conrad G, Tschan F, Hunziker PR. Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests. Resuscitation. 2004;60(1):51-6. http://dx.doi.org/10.1016/j.resuscitation.2003.08.004
  7. Flin R, Maran N. Identifying and training non-technical skills for teams in acute medicine. Quality and Safety in Health Care. 2004;13:i80-4. http://dx.doi.org/10.1136/qshc.2004.009993
  8. Mitchell L, Flin R. Non-technical skills of the operating theatre scrub nurse: literature review. Journal of Advanced Nursing. 2008;63(1):15-24. http://dx.doi.org/10.1111/j.1365-2648.2008.04695.x
  9. Yule S, Flin R, Maran N, Paterson-Brown S. Non-technical skills for surgeons in the operating room: a review of the literature. Surgery. 2006;139(2):140-9. http://dx.doi.org/10.1016/j.surg.2005.06.017
  10. Fletcher G, McGeorge P, Flin R, Glavin R, Maran N. Anaesthetists' non-technical skills(ANTS): evaluation of a behavioural marker system. British Journal of Anaesthesia. 2003;90(5):580-8. http://dx.doi.org/10.1093/bja/aeg112
  11. Andersen P, Jensen MK, Lippert A, O/ stergaard D. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams. Resuscitation, 2010;81(6):695-702. http://dx.doi.org/10.1016/j.resuscitation.2010.01.024
  12. Walker S, Brett S, McKay A, Lambden S, Vincent C, Sevdalis N. Observation skill-based clinical assessment tool for resuscitation (OSCAR): development and validation. Resuscitation. 2011;82(7):835-44. http://dx.doi.org/10.1016/j.resuscitation.2011.03.009
  13. Cooper S, Cant R, Porter J. Rating emergency teamwork performance development of the team emergency assessment measure(TEAM). Resuscitation. 2010;81(4):446-52. http://dx.doi.org/10.1016/j.resuscitation.2009.11.027
  14. Kim JY, Jun SS, Kim DH, Choi SS. Knowledge and attitude toward BLS and provided CPR education among nurses at general wards in Pusan. Journal of Korean Academy of Fundamental Nursing. 2008;15(2):143-52.
  15. Oh SI, Han SS. A study on the sustainable effects of reeducation on cardiopulmonary resuscitation on nurses' knowledge and skills. Journal of Korean Academic Nursing. 2008;38(3):383-92. https://doi.org/10.4040/jkan.2008.38.3.383
  16. Park JS, Jeon HR. The effect of basic life support education using a standardized basic life support video program in nurses' cardiopulmonary resuscitation knowledge, attitude and performance. The Journal of Korean Academic Society of Nursing Education. 2010;16(2):301-11. https://doi.org/10.5977/JKASNE.2010.16.2.301
  17. Pyo MY, Kim JY, Sohn, JO, Lee ES, Kim HS, Kim KO, et al. The effects of an advanced cardiac life support training via smart phone's simulation application on nurses' knowledge and learning satisfaction. Journal of Korean Clinical Nursing Research. 2012;18(2):228-38. https://doi.org/10.22650/JKCNR.2012.18.2.228
  18. Basic life support for healthcare providers. Dallas, TX: American Heart Association; 2010.
  19. Lynn MR. Determination and quantification of content validity. Nursing Research. 1986;35(6):382-5.
  20. Kim EJ, Lee KR, Lee MH, Kim JY. Nurses' cardiopulmonary resuscitation performance during the first 5 minutes in in-situ simulated cardiac arrest. Journal of Korean Academic Nursing. 2010;42(3):361-8. http://dx.doi.org/10.4040/jkan.2012.42.3.361
  21. Hunziker S, Buhlmann C, Tschan F, Balestra G, Legeret C, Schumacher C, et al. Brief leadership instructions improve cardiopulmonary resuscitation in a high-fidelity simulation: a randomized controlled trial. Critical Care Medicine. 2010;38(4):1086-91. http://dx.doi.org/10.1097/CCM.0b013e3181cf7383
  22. Siassakos D, Bristowe K, Draycott TJ, Angouri J, Hambly H, Winter C, et al. Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study. BJOG: An International Journal of Obstetrics and Gynaecology. 2011;118(5):596-607. http://dx.doi.org/10.1111/j.1471-0528.2010.02843.x
  23. Yeung JH, Ong GJ, Davies RP, Gao F, Perkins GD. Factors affecting team leadership skills and their relationship with quality of cardiopulmonary resuscitation. Critical Care Medicine. 2012;40(9):2617-21. http://dx.doi.org/10.1097/CCM.0b013e3182591fda
  24. Cooper SJR, Wakelam A. Leadership of resuscitation teams: "lighthouse leadership." Resuscitation. 1999;42(1):27-45. http://dx.doi.org/10.1016/S0300-9572(99)00080-5
  25. Agency for Healthcare Research and Quality. Team strategies & tools to enhance performance and patient safety [Internet]. U.S. Department of Health & Human Services: Agency for Healthcare Research and Quality [cited 2014 June 23]. Available from: http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/pocketguide.pdf
  26. Gilligan P, Bhatarcharjee C, Knight G, Smith M, Hegarty D, Shenton A, et al. To lead or not to lead?: prospective controlled study of emergency nurses' provision of advanced life support team leadership. Emergency Medicine Journal. 2005;22(9):628-32. https://doi.org/10.1136/emj.2004.015321
  27. Norris EM, Lockey AS. Human factors in resuscitation teaching. Resuscitation. 2012;83(4):423-7. http://dx.doi.org/10.1016/j.resuscitation.2011.11.001
  28. Chan PS, Krumholz HM, Nichol G, Nallamothu BK. Delayed time to defibrillation after in-hospital cardiac arrest. The New England Journal of Medicine. 2008;358(1):9-17. http://dx.doi.org/10.1056/NEJMoa0706467

Cited by

  1. Attitudes and Type Analysis of Cardiopulmonary Resuscitation among Hospital Nurses in Emergency Room and Intensive Care Units vol.29, pp.5, 2017, https://doi.org/10.7475/kjan.2017.29.5.484
  2. 간호사를 위한 모바일 웹기반 심폐소생술 융합교육의 효과 vol.9, pp.3, 2015, https://doi.org/10.15207/jkcs.2018.9.3.307
  3. 2015, https://doi.org/10.3390/healthcare9101253
  4. 2015, https://doi.org/10.5762/kais.2020.21.10.115