Abstract 73: Improving Teamwork Perceptions and Cardiopulmonary Resuscitation Performance by High-Fidelity Simulation-Based Teamwork Training
Introduction: The quality of cardiopulmonary resuscitation (CPR) performance influences patient's outcome. Besides individual technical knowledge and skills, teamwork perceptions have an impact on team performance, and consequently on resuscitation quality. This study aimed to investigate the impacts of high-fidelity simulation (HFS)-based teamwork training on team perceptions and CPR performance.
Methods: This was a prospective, case-controlled study. A four-scenario, HFS-based teamwork training program was developed and implemented from November 2007 to February 2008. In addition to resuscitation skills, the program focused on teaching teamwork competencies, including leadership, communication, situation monitoring, and mutual support. Case scenarios were simulated using a high-fidelity mannequin simulator in a simulated emergency department (ED) setting. Audio-visual assisted feedback was given by facilitators after each scenario. A standardized questionnaire for assessment of teamwork performance was developed, using 5-point Likert scales. All participants completed the questionnaires immediately after each scenario, according to their performance during that simulation session. Both the first and last case scenarios were patients of out-of-hospital cardiac arrest. CPR performance including compression rate, no-flow ratio, and initiation time of defibrillation was measured by reviewing the videos.
Results: A total of 83 ED staffs, including 24 residents and 59 nurses, were enrolled. Teamwork perceptions improved significantly after the simulation training course (p<0.001). For CPR performance, there was a trend toward decreased hyperventilation rate (19.1±5.6 vs. 14.8±8.2 min-1, p=0.10), increased chest compression rate (102.4±17.1 vs. 110.4±15.2 min-1, p=0.12), and faster initiation of defibrillation (93.4±26.9 vs. 69.1±39.0 secs, p=0.09) after the training course. No-flow fraction (0.23±0.07 vs. 0.17±0.08, p=0.01), initiation of intubation (99.1±40.6 vs. 77.0±37.0 secs, p=0.02) and intravenous access (86.9±37.7 vs. 63.4±33.8 secs, p=0.02) were significantly improved.
Conclusion: HFS-based teamwork training is effective in improving teamwork perceptions and some aspects of CPR performance.
- © 2011 by American Heart Association, Inc.