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Fernández Castillo G, Khalid M, Salas E. Beyond communication: an update on transforming healthcare teams. Front Med (Lausanne) 2024; 11:1282173. [PMID: 38449884 PMCID: PMC10915010 DOI: 10.3389/fmed.2024.1282173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 02/01/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
| | | | - Eduardo Salas
- Making Effective Teams Laboratory, Department of Psychological Science, Rice University, Houston, TX, United States
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2
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Regional and clinical guidelines for prevention and care of obstetric anal sphincter injuries - A critical frame analysis. Midwifery 2023; 119:103608. [PMID: 36739637 DOI: 10.1016/j.midw.2023.103608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Policy documents govern how the prevention and care of obstetric anal sphincter injuries (OASIS) are implemented. Thus, in the absence of Swedish national guidelines on OASIS, differing views may be visible in the regional and local policy documents. Therefore, we aimed to analyse regional and local policies, guidelines, and care programs on the prevention of OASIS and care for OASIS-affected women in a Swedish context by applying a critical frame analysis inspired by Verloo. DESIGN AND SETTING A cross-sectional study of existing policy documents from Swedish healthcare regions was performed. The documents were analysed using Verloo's critical frame analysis. FINDINGS We found that OASIS was framed as a preventable problem addressed by skilled protective manoeuvres of the healthcare staff. Education, communication, and teamwork were three frames of crucial solutions to minimise the prevalence of OASIS. However, complicating power dimensions between professional groups and between professionals and birthing women were identified. Furthermore, several discursive struggles were found, predominantly regarding the scientific evidence for the suggested prevention and care. CONCLUSION The policy documents emphasised that OASIS is preventable, and improved education, communication, and teamwork could diminish the OASIS prevalence. Nevertheless, power dimensions and discursive struggles may challenge the preventive efforts. Furthermore, each Swedish region has the sovereignty to develop its policies, which was reflected in our findings and may imply inequities in care provision. Thus, there is an urgent need to develop comprehensive national high-quality guidelines of high quality for OASIS prevention and care so that all women giving birth have access to equal care and treatment in Sweden.
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Hellmeyer L, Zinn-Kirchner Z, Königbauer JT. Maternal mortality in the city of Berlin: consequences for perinatal healthcare. J Perinat Med 2023; 51:182-187. [PMID: 34968015 DOI: 10.1515/jpm-2021-0604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The fifth of the United Nations' Millennium Development Goals proposed for 2000-2015 was to improve maternal health, which has only partially been achieved. Worldwide, the maternal mortality ratio is currently estimated at 216/100.000 livebirths, compared to 380/100,000 in 1990. As yet, there has been no published comprehensive analysis of maternal mortality data as it pertains to Berlin and by extension Germany. Aim of the study was to evaluate and analyze the maternal mortality rate of Berlin as a result of shortcomings in healthcare provision and identify possible solutions. METHODS The Institute for Quality and Transparency in the Healthcare Sector sourced external quality control from the Qualitätsbüro Berlin to provide maternal mortality data from Berlin hospitals from 2007 to 2020. RESULTS Nineteen maternal deaths were registered between 2007 and 2020 in total. Case analysis shows that two main events occur: thrombosis and hemorrhage at 31.6%, respectively, followed by hypertensive disorder (15.8%), and sepsis (15.8%). After detailed analysis of each case report, we determined 8/19 (42.1%) maternal deaths as being potentially preventable given slightly altered circumstances. CONCLUSIONS The system of registration of perinatal data in Germany does not allow for a comprehensive recording of maternal death and requires alteration to provide a more accurate picture of the phenomenon of maternal mortality; presumably, there exist twice as many unreported cases. Symptoms, risks, and primary prevention tactics of thromboembolism during pregnancy and birth should be imparted to every licensed professional in individual hospital settings, along with evidence-based simulation training for the event of obstetric or prepartum hemorrhage.
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Affiliation(s)
- Lars Hellmeyer
- Vivantes Klinikum im Friedrichshain, Academic Hospital of Charité - Universitätsklinikum Berlin, Berlin, Germany
| | | | - Josefine T Königbauer
- Vivantes Klinikum im Friedrichshain, Academic Hospital of Charité - Universitätsklinikum Berlin, Berlin, Germany
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Kaneko RMU, Monteiro I, Lopes MHBDM. Form for planning and elaborating high fidelity simulation scenarios: A validation study. PLoS One 2022; 17:e0274239. [PMID: 36170273 PMCID: PMC9518865 DOI: 10.1371/journal.pone.0274239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022] Open
Abstract
Every human being has the right to safe, dignified and harm-free care in health institutions. High fidelity simulation has been used in teaching for the training and continuing education of health professionals to promote quality, safe and humanized patient care. Elaborating scenarios is an important phase to provide a simulation-based experience, and is relevant in the teaching-learning process. The objective of this study was to validate the content and applicability of the High Fidelity Simulation Scenario Planning and Development Form and its Operational Manual. The form could be used to development of scenarios to medicine, nursing, physiotherapy and as well as other specialties in the healthcare. This was a methodological validation study of the form and its manual content by experts in simulation and its feasibility, conducted in two phases: Phase 1: eight experts were selected using the “snowball” sampling technique to validate the content measured by the content validity index; Phase 2 (test): the form and its operational manual validated by the experts were made available to 28 participants in order to elaborate scenarios for the feasibility assessment and participation in the focus group. All items in the form and in the operational manual reached a content validity index above 0.80. The total content validity index was 0.98. The evaluation of the usability of the instruments carried out by the participants reached a percentage above 96.43% in all alternatives except for the item “It was easy to use the form to build your scenario” (75%). Eight participants were present in the focus group. Focus group discussions were categorized into completeness, practicality and usefulness according to comments and suggestions. The form and its operational manual proved to be valid instruments.
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Affiliation(s)
| | - Inês Monteiro
- Faculty of Nursing, University of Campinas, Campinas, São Paulo, Brazil
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Schmiedhofer M, Derksen C, Dietl JE, Haeussler F, Strametz R, Huener B, Lippke S. The Impact of a Communication Training on the Birth Experience: Qualitative Interviews with Mothers after Giving Birth at Obstetric University Departments in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811481. [PMID: 36141754 PMCID: PMC9517065 DOI: 10.3390/ijerph191811481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 05/27/2023]
Abstract
(1) Background: Patient safety is a pressing issue in healthcare. Besides economical and organizational issues, human factors play a crucial role in providing safe care. Safe and clear communication on both the healthcare workers' and patients' sides contribute to the avoidance of medical errors and increase patients' and healthcare workers' satisfaction. Globally, the incidence of experiencing at least one adverse event in obstetrics is about 10%, of which half are classified as preventable. According to international research, improving communication skills may decrease preventable adverse events. The research question was to what extent communication training for pregnant women impacts the quality of communication and mutual understanding during birth. (2) Methods: Communication interventions with pregnant women were conducted in two German university obstetric departments in a mixed methods research design, based on the Health Action Process Approach. The online classes covered the awareness of personal wishes, the understanding and usage of communication strategies, self-efficacy and empathy. This study presents the qualitative results. Out of 142 mothers who answered two questionnaires before the communication training and after the birth, 24 in-depth semistructured interviews were conducted to explore the subjective impact of the communication training. The results were analyzed with qualitative content analysis. (3) Results: The majority of participants felt incentivized to be aware of their personal wishes for birth and to express them. Perceived positive experiences with sufficient competency in communication, empathy and mutual understanding outweighed negative treatments and experiences in the hospital, some of which could be attributed to structural problems. (4) Discussion: The reported positive effects of the communication training underline the need but also the potential for communication lessons to reflect and improve communication skills in obstetrics. However, negative experiences due to structural problems in the healthcare system may be buffered by communication skills but not solved.
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Affiliation(s)
- Martina Schmiedhofer
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Christina Derksen
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Johanna Elisa Dietl
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Freya Haeussler
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
| | - Reinhard Strametz
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Wiesbaden Business School, Rhein Main University of Applied Science, 65183 Wiesbaden, Germany
| | - Beate Huener
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
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Paige JT, Bonanno LS, Garbee DD, Yu Q, Kiselov VJ, Badeaux JA, Martin JB, Kalil DM, Devlin RJ. Team Training for Interprofessional Insight, Networking and Guidance (T 2IPING) points: a study protocol. Simul Healthc 2022. [DOI: 10.54531/fqax8042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Effective teamwork remains a crucial component in providing high-quality care to patients in today’s complex healthcare environment. A prevalent ‘us’ versus ‘them’ mentality among professions, however, impedes reliable team function in the clinical setting. More importantly, its corrosive influence extends to health professional students who model the ineffective behaviour as they learn from practicing clinicians. Simulation-based training (SBT) of health professional students in team-based competencies recognized to improve performance could potentially mitigate such negative influences. This quasi-experimental prospective study will evaluate the effectiveness and impact of incorporating a multi-year, health science centre-wide SBT curriculum for interprofessional student teams. It targets health professional students from the Schools of Medicine, Nursing and Allied Health at Louisiana State University (LSU) Health New Orleans. The intervention will teach interprofessional student teams key team-based competencies for highly reliable team behaviour using SBT. The study will use the Kirkpatrick framework to evaluate training effectiveness. Primary outcomes will focus on the impact of the training on immediate improvements in team-based skills and attitudes (Level 2). Secondary outcomes include students’ perception of the SBT (Level 1), its immediate impact on attitudes towards interprofessional education (Level 2) and its impact on team-based attitudes over time (Level 3).The Institutional Review Board at LSU Health New Orleans approved this research as part of an exempt protocol with a waiver of documentation of informed consent due to its educational nature. The research description for participants provides information on the nature of the project, privacy, dissemination of results and opting out of the research.
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Affiliation(s)
- John T Paige
- 1Department of Surgery, Louisiana State University (LSU) Health New Orleans School of Medicine, New Orleans, LA, USA
| | - Laura S Bonanno
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Deborah D Garbee
- 3Office of the Dean, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Qingzhao Yu
- 4Department of Biostatistics, LSU Health New Orleans School of Public Health, New Orleans, LA
| | | | - Jennifer A Badeaux
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Jennifer B Martin
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - David M Kalil
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Raymond J Devlin
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
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Paige JT, Bonanno LS, Garbee DD, Yu Q, Kiselov VJ, Badeaux JA, Martin JB, Kalil DM, Devlin RJ. Team Training for Interprofessional Insight, Networking and Guidance (T 2IPING) points: a study protocol. Simul Healthc 2022. [DOI: 10.54531/ijohs/ijaa015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Effective teamwork remains a crucial component in providing high-quality care to patients in today’s complex healthcare environment. A prevalent ‘us’ versus ‘them’ mentality among professions, however, impedes reliable team function in the clinical setting. More importantly, its corrosive influence extends to health professional students who model the ineffective behaviour as they learn from practicing clinicians. Simulation-based training (SBT) of health professional students in team-based competencies recognized to improve performance could potentially mitigate such negative influences. This quasi-experimental prospective study will evaluate the effectiveness and impact of incorporating a multi-year, health science centre-wide SBT curriculum for interprofessional student teams. It targets health professional students from the Schools of Medicine, Nursing and Allied Health at Louisiana State University (LSU) Health New Orleans. The intervention will teach interprofessional student teams key team-based competencies for highly reliable team behaviour using SBT. The study will use the Kirkpatrick framework to evaluate training effectiveness. Primary outcomes will focus on the impact of the training on immediate improvements in team-based skills and attitudes (Level 2). Secondary outcomes include students’ perception of the SBT (Level 1), its immediate impact on attitudes towards interprofessional education (Level 2) and its impact on team-based attitudes over time (Level 3).The Institutional Review Board at LSU Health New Orleans approved this research as part of an exempt protocol with a waiver of documentation of informed consent due to its educational nature. The research description for participants provides information on the nature of the project, privacy, dissemination of results and opting out of the research.
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Affiliation(s)
- John T Paige
- 1Department of Surgery, Louisiana State University (LSU) Health New Orleans School of Medicine, New Orleans, LA, USA
| | - Laura S Bonanno
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Deborah D Garbee
- 3Office of the Dean, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Qingzhao Yu
- 4Department of Biostatistics, LSU Health New Orleans School of Public Health, New Orleans, LA
| | | | - Jennifer A Badeaux
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Jennifer B Martin
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - David M Kalil
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
| | - Raymond J Devlin
- 2Nurse Anesthesia Program, LSU Health New Orleans School of Nursing, New Orleans, LA
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Arvidsson L, Lindberg M, Skytt B, Lindberg M. Healthcare personnel's working conditions in relation to risk behaviours for organism transmission: A mixed-methods study. J Clin Nurs 2021; 31:878-894. [PMID: 34219318 DOI: 10.1111/jocn.15940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/18/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission. BACKGROUND Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients. DESIGN A mixed-methods convergent design. METHODS Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research. RESULTS Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients. CONCLUSIONS These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety. RELEVANCE FOR CLINICAL PRACTICE The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.
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Affiliation(s)
- Lisa Arvidsson
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden
| | - Magnus Lindberg
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden
| | - Bernice Skytt
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Lindberg
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle, Sweden
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Sotto KT, Hedli LC, Sie L, Padua K, Yamada N, Lee H, Halamek L, Daniels K, Nathan-Roberts D, Austin NS. Single-center task analysis and user-centered assessment of physical space impacts on emergency Cesarean delivery. PLoS One 2021; 16:e0252888. [PMID: 34111177 PMCID: PMC8191948 DOI: 10.1371/journal.pone.0252888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/25/2021] [Indexed: 11/29/2022] Open
Abstract
Cesarean delivery is the most common surgery performed in the United States, accounting for approximately 32% of all births. Emergency Cesarean deliveries are performed in the event of critical maternal or fetal distress and require effective collaboration and coordination of care by a multidisciplinary team with a high level of technical expertise. It is not well understood how the physical environment of the operating room (OR) impacts performance and how specialties work together in the space.
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Affiliation(s)
- Kenji T. Sotto
- San José State University, San Jose, California, United States of America
- * E-mail: (KTS); (DNR)
| | - Laura C. Hedli
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Lillian Sie
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Kimber Padua
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Nicole Yamada
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Henry Lee
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Louis Halamek
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Pediatrics, Stanford University, Stanford, California, United States of America
| | - Kay Daniels
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Obstetrics and Gynecology, Stanford University, Stanford, California, United States of America
| | - Dan Nathan-Roberts
- San José State University, San Jose, California, United States of America
- * E-mail: (KTS); (DNR)
| | - Naola S. Austin
- The Safety Learning Laboratory for Neonatal and Maternal Care, Stanford University, Stanford, California, United States of America
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, United States of America
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Paige JT, Garbee DD, Yu Q, Zahmjahn J, Baroni de Carvalho R, Zhu L, Rusnak V, Kiselov VJ. Brick in the wall? Linking quality of debriefing to participant learning in team training of interprofessional students. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2021; 7:360-365. [DOI: 10.1136/bmjstel-2020-000685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/03/2022]
Abstract
BackgroundThe evidence for the conventional wisdom that debriefing quality determines the effectiveness of learning in simulation-based training is lacking. We investigated whether the quality of debriefing in using simulation-based training in team training correlated with the degree of learning of participants.MethodsForty-two teams of medical and undergraduate nursing students participated in simulation-based training sessions using a two-scenario format with after-action debriefing. Observers rated team performance with an 11-item Teamwork Assessment Scales (TAS) instrument (three subscales, team-based behaviours (5-items), shared mental model (3-items), adaptive communication and response (3-items)). Two independent, blinded raters evaluated video-recorded facilitator team prebriefs and debriefs using the Objective Structured Assessment of Debriefing (OSAD) 8-item tool. Descriptive statistics were calculated, t-test comparisons made and multiple linear regression and univariate analysis used to compare OSAD item scores and changes in TAS scores.ResultsStatistically significant improvements in all three TAS subscales occurred from scenario 1 to 2. Seven faculty teams taught learners with all scores ≥3.0 (except two) for prebriefs and all scores ≥3.5 (except one) for debriefs (OSAD rating 1=done poorly to 5=done well). Linear regression analysis revealed a single statistically significant correlation between debrief engagement and adaptive communication and response score without significance on univariate analysis.ConclusionsQuality of debriefing does not seem to increase the degree of learning in interprofessional education using simulation-based training of prelicensure student teams. Such a finding may be due to the relatively high quality of the prebrief and debrief of the faculty teams involved in the training.
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Barriers and Facilitators of Safe Communication in Obstetrics: Results from Qualitative Interviews with Physicians, Midwives and Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030915. [PMID: 33494448 PMCID: PMC7908168 DOI: 10.3390/ijerph18030915] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/13/2021] [Accepted: 01/17/2021] [Indexed: 11/17/2022]
Abstract
Patient safety is an important objective in health care. Preventable adverse events (pAEs) as the counterpart to patient safety are harmful incidents that fell behind health care standards and have led to temporary or permanent harm or death. As safe communication and mutual understanding are of crucial importance for providing a high quality of care under everyday conditions, we aimed to identify barriers and facilitators that impact safe communication in obstetrics from the subjective perspective of health care workers. A qualitative study with 20 semi-structured interviews at two university hospitals in Germany was conducted to explore everyday perceptions from a subjective perspective (subjective theories). Physicians, midwives, and nurses in a wide span of professional experience and positions were enrolled. We identified a structural area of conflict at the professional interface between midwives and physicians. Mandatory interprofessional meetings, acceptance of subjective mistakes, mutual understanding, and debriefings of conflict situations are reported to improve collaboration. Additionally, emergency trainings, trainings in precise communication, and handovers are proposed to reduce risks for pAEs. Furthermore, the participants reported time-constraints and understaffing as a huge burden that hinders safe communication. Concluding, safety culture and organizational management are closely entwined and strategies should address various levels of which communication trainings are promising.
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12
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Bogren M, Denovan A, Kent F, Berg M, Linden K. Impact of the Helping Mothers Survive Bleeding After Birth learning programme on care provider skills and maternal health outcomes in low-income countries - An integrative review. Women Birth 2020; 34:425-434. [PMID: 33041235 DOI: 10.1016/j.wombi.2020.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To improve maternal health outcomes, highly competent healthcare providers are needed. One strategy used to improve performance among healthcare providers is simulation-based learning. An integrative review was designed with the aim of synthesising available research on Helping Mothers Survive (HMS), a learning programme used in low-income countries, and its impact on care provider skills and maternal health outcomes. METHOD A systematic search was conducted in June 2020 in CINAHL, PubMed, Scopus, and Web of Science. All stages of inclusion, quality assessment, and data extraction were done independently by four reviewers. A narrative synthesis was used for the outcomes of care provider skills and knowledge, as well as maternal health outcomes. FINDINGS The search identified 50 articles, 22 of which were excluded due to being duplicates, 16 based on their title and abstract, and two based on their full text. Eleven papers were included in the synthesis: eight quantitative, two qualitative, and one mixed-method study, originating from India, Malawi, Tanzania, Uganda, and Zanzibar. The Helping Mothers Survive-Bleeding After Birth (HMS-BAB) learning programme was found to have a positive impact on care providers' competencies and maternal health outcomes, with a reduced number of postpartum haemorrhages and a reduction in maternal mortality. CONCLUSION The HMS-BAB learning programme has the potential to increase competence among care providers and improve maternal health outcomes in low-income settings. A successful use of the programme to maintain improved care routines for mothers requires multi-professional teams, facility readiness, a low-dose high-frequency approach, a local coordinator, and accountability and ownership.
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Affiliation(s)
- Malin Bogren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe 1, 413 46 Gothenburg, Sweden.
| | - Anna Denovan
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe 1, 413 46 Gothenburg, Sweden
| | - Felicity Kent
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe 1, 413 46 Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe 1, 413 46 Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens Backe 1, 413 46 Gothenburg, Sweden
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Dodge LE, Nippita S, Hacker MR, Intondi EM, Ozcelik G, Paul ME. Long-term effects of teamwork training on communication and teamwork climate in ambulatory reproductive health care. J Healthc Risk Manag 2020; 40:8-15. [PMID: 32761729 DOI: 10.1002/jhrm.21440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/17/2020] [Accepted: 06/25/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND We previously reported an association between team training in the ambulatory setting and improvements in team climate at 6 and 12 months, but it is unknown whether improvements persist at 2 years. STUDY DESIGN From 2014 to 2015, we enrolled 20 organizations, each operating a varying number of health centers, into a teamwork training initiative. We evaluated teamwork outcomes at baseline and 2 years using a communication behaviors assessment, the TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ), and the Patients' Insights and Views of Teamwork (PIVOT) survey. RESULTS At 2 years, use of TeamSTEPPS® tools and strategies remained increased compared to baseline at many health centers; results ranged from 32% of centers reporting increased use of pauses to identify the patient to 91% reporting increased use of standardized language. Staff T-TPQ responses indicated that TeamSTEPPS® implementation was associated with improved perceptions of teamwork in approximately half (49%) of statements at 2 years. Significant improvements occurred in over half of PIVOT survey statements, and patient satisfaction was significantly greater at 2 years compared to baseline. CONCLUSIONS Patient and staff views of teamwork were significantly improved 2 years after TeamSTEPPS® implementation in ambulatory reproductive health care centers, demonstrating positive long-term effects of teamwork training.
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Affiliation(s)
- Laura E Dodge
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, 02215.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02215
| | - Siripanth Nippita
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, 02215
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, 02215.,Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02215
| | | | - Guzey Ozcelik
- Affiliates Risk Management Services, Inc., New York, NY, 10001
| | - Maureen E Paul
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, 02215.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, 02215.,Affiliates Risk Management Services, Inc., New York, NY, 10001
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Barger MK. Current Resources for Evidence-Based Practice, May/June 2020. J Midwifery Womens Health 2020; 65:417-423. [PMID: 32301574 DOI: 10.1111/jmwh.13115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 03/13/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Mary K Barger
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research, University of San Diego, San Diego, California
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