Document Detail


Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams.
MedLine Citation:
PMID:  20570292     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Resuscitation of pediatric cardiac patients involves unique and complex physiology, requiring multidisciplinary collaboration and teamwork. To optimize team performance, we created a multidisciplinary Crisis Resource Management training course that addressed both teamwork and technical skill needs for the pediatric cardiac intensive care unit. We sought to determine whether participation improved caregiver comfort and confidence levels regarding future resuscitation events. METHODS: We developed a simulation-based, in situ Crisis Resource Management curriculum using pediatric cardiac intensive care unit scenarios and unit-specific resuscitation equipment, including an extracorporeal membrane oxygenation circuit. Participants replicated the composition of a clinical team. Extensive video-based debriefing followed each scenario, focusing on teamwork principles and technical resuscitation skills. Pre- and postparticipation questionnaires were used to determine the effects on participants' comfort and confidence regarding participation in future resuscitations. RESULTS: A total of 182 providers (127 nurses, 50 physicians, 2 respiratory therapists, 3 nurse practitioners) participated in the course. All participants scored the usefulness of the program and scenarios as 4 of 5 or higher (5 = most useful). There was significant improvement in participants' perceived ability to function as a code team member and confidence in a code (P < .001). Participants reported they were significantly more likely to raise concerns about inappropriate management to the code leader (P < .001). CONCLUSIONS: We developed a Crisis Resource Management training program in a pediatric cardiac intensive care unit to teach technical resuscitation skills and improve team function. Participants found the experience useful and reported improved ability to function in a code. Further work is needed to determine whether participation in the Crisis Resource Management program objectively improves team function during real resuscitations.
Authors:
Catherine K Allan; Ravi R Thiagarajan; Dorothy Beke; Annette Imprescia; Liana J Kappus; Alexander Garden; Gavin Hayes; Peter C Laussen; Emile Bacha; Peter H Weinstock
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-06-08
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-52     Citation Subset:  AIM; IM    
Copyright Information:
2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Cardiology, Children's Hospital Boston, Boston, Mass 02115, USA. catherine.allan@cardio.chboston.org
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MeSH Terms
Descriptor/Qualifier:
Anxiety / etiology,  prevention & control*
Attitude of Health Personnel*
Boston
Cardiology Service, Hospital* / organization & administration
Cardiopulmonary Resuscitation / education*
Clinical Competence*
Curriculum
Education, Medical, Continuing* / organization & administration
Group Processes
Health Knowledge, Attitudes, Practice
Humans
Inservice Training
Intensive Care Units, Pediatric* / organization & administration
Manikins
Patient Care Team* / organization & administration
Patient Simulation*
Program Development
Program Evaluation
Questionnaires
Task Performance and Analysis
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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