Korean J Adult Nurs.  2015 Apr;27(2):146-155. 10.7475/kjan.2015.27.2.146.

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

• Kim EJ
• Lee KR

• KMID: 2298129
• DOI: http://doi.org/10.7475/kjan.2015.27.2.146

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.

MeSH Terms

Cardiopulmonary Resuscitation
Checklist
Heart Arrest*
Leadership
Manikins
Patient Simulation
Resuscitation*
Seoul
Video Recording

Reference

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., Hun-ziker 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 inacutemedicine. Quality andSafety inHealthCare. 2004. 13:i80–4. http://dx.doi.org/10.1136/qshc.2004.009993.

8.Mitchell L., Flin R. Non-technicalskills ofthe 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-technicalskills 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 mea-sure(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.

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.

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.

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.0b013e3181cf7383̈.

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 control-ledstudyofemergencynurses' provision of advanced life support team leadership. Emergency Medicine Journal. 2005. 22(9):628–32.

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.