scholarly journals LO72: Assessing non-technical skills in prehospital ad hoc team resuscitation

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S34
Author(s):  
J. Evans ◽  
D. Lingard ◽  
D. Peddle ◽  
M. Slack
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Full Text ◽  
Ad Hoc ◽  
Technical Skills ◽  
Skills Training ◽  
Educational Models ◽  
Successful Resuscitation ◽  
Acute Care Settings ◽  
Ad Hoc Teams

Introduction: Successful resuscitation in the ED cannot occur without a viable patient, and in many cases patient viability is dependent upon optimal prehospital resuscitation performed by ad hoc teams formed in real time. Currently, little is known about the cognitive and interpersonal skills, or non-technical skills, that are essential for effective team collaboration under these conditions. We have completed a scoping review to provide a state of the literature and develop a taxonomy of the non-technical skills pertinent to ad hoc teams in prehospital settings. Methods: Our scoping review searched four databases (EMBASE, Medline, Cinahl, and Psychinfo) for articles related to resuscitation in acute care settings. No date criteria were applied, but only full text articles written in English were included. Articles underwent two-reviewer title & abstract screening, full text screening, and analysis. A quality review asked three questions: Are keywords defined? Is the article well-situated within the existing literature? Does the article contribute back to the existing body of knowledge? Although statistical analyses are not appropriate for this scoping review, analysis included a descriptive-analytical framework for organizing data. Results: Of 6932 screened articles, 38 were included in analysis, five articles examined prehospital teams, and one addressed the ad hoc nature of these teams. Only one of these articles met our three quality criteria. Nevertheless, our analysis suggests a rudimentary taxonomy whereby the primary objective of a team leader is to overcome this barrier by facilitating the development of optimal team situational awareness, fostered through timely and accurate briefings with closed-loop communication. Conclusion: This scoping review has identified that non-technical skills pertaining to resuscitation in acute care settings are becoming a widely examined phenomenon; however, few studies contribute in any meaningful way to our understanding of how non-technical skills training can be tailored to those performing as members of ad hoc prehospital resuscitation teams. As the need for interprofessional training is becoming more pressing, we anticipate this review will provide essential guidance for future inquiry as well as design for both educational models and organizational systems-based interventions.

scholarly journals Non-technical skills in out-of-hospital cardiac arrest management: A scoping review

2020 ◽  
Vol 17 ◽  
Author(s):  
Stefanie Cormack ◽  
Steve Scott ◽  
Alex Stedmon
Keyword(s):  
Cardiac Arrest ◽  
Team Performance ◽  
Scoping Review ◽  
Ad Hoc ◽  
Relevant Literature ◽  
Technical Skills ◽  
Literature Base ◽  
Ad Hoc Teams ◽  
Study Designs ◽  
Hospital Cardiac Arrest

IntroductionCurrent United Kingdom resuscitation guidance advocates the use of non-technical skills (NTS) such as teamwork, decision-making and communication for ad-hoc teams managing an out-of-hospital cardiac arrest (OHCA). It is unknown which NTS are advantageous or commonly used, or if there is supporting literature. This scoping review sought to establish a literature base and identify key NTS relevant to ad-hoc teams managing an OHCA.MethodsArksey and O’Malley’s five-stage framework was used to perform a scoping review to identify relevant literature from the medical domain. Thematic analyses were used to identify relevant NTS in relation to OHCA management.ResultsA total of 12 articles were identified and selected for detailed analysis. The articles represented a range of study designs, with most commenting on observed simulated practice from in-hospital practice. There was a paucity of literature for NTS associated with ad-hoc OHCA teams. Three common NTS were identified: leadership, teamwork and communication, with improved team performance associated with a hands-off team leader. Barriers were also identified and included low confidence in communicating and hierarchical difficulties in resuscitation teams. Conclusion We believe this scoping review provides the first comprehensive review of its kind and identifies important knowledge gaps, NTS themes and recommendations for paramedic-led OHCA teams. Three NTS from in-hospital cardiac arrest management can be related to OHCA management, but further research is needed to identify specific NTS for ad-hoc teams managing an OHCA.  

Methods used to attribute costs avoided from pharmacist interventions in acute care: A scoping review

2021 ◽  
Author(s):  
Sujita W Narayan ◽  
Ivo Abraham ◽  
Brian L Erstad ◽  
Curtis E Haas ◽  
Arthur Sanders ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Pharmacy Practice ◽  
Economic Implications ◽  
Medline Search ◽  
Cost Avoidance ◽  
Harmful Consequence ◽  
Pharmacist Interventions ◽  
Acute Care Settings ◽  
Human Participants

Abstract Purpose Cost-avoidance studies are common in pharmacy practice literature. This scoping review summarizes, critiques, and identifies current limitations of the methods that have been used to determine cost avoidance associated with pharmacists’ interventions in acute care settings. Methods An Embase and MEDLINE search was conducted to identify studies that estimated cost avoidance from pharmacist interventions in acute care settings. We included studies with human participants and articles published in English from July 2010 to January 2021, with the intent of summarizing the evidence most relevant to contemporary practice. Results The database search retrieved 129 articles, of which 39 were included. Among these publications, less than half (18 of 39) mentioned whether the researchers assigned a probability for the occurrence of a harmful consequence in the absence of an intervention; thus, a 100% probability of a harmful consequence was assumed. Eleven of the 39 articles identified the specific harm that would occur in the absence of intervention. No clear methods of estimating cost avoidance could be identified for 7 studies. Among all 39 included articles, only 1 attributed both a probability to the potential harm and identified the cost specific to that harm. Conclusion Cost-avoidance studies of pharmacists’ interventions in acute care settings over the last decade have common flaws and provide estimates that are likely to be inflated. There is a need for guidance on consistent methodology for such investigations for reporting of results and to confirm the validity of their economic implications.

scholarly journals Reasonable adjustments for people with intellectual disability in acute care: a scoping review of the evidence

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e039647
Author(s):  
Mairead Moloney ◽  
Therese Hennessy ◽  
Owen Doody
Keyword(s):  
Intellectual Disability ◽  
Acute Care ◽  
Scoping Review ◽  
Service Provision ◽  
Care Setting ◽  
Acute Care Setting ◽  
Inclusion Criteria ◽  
Health Service Provision ◽  
Acute Care Settings ◽  
Fair Access

ObjectivesPeople with intellectual disability are vulnerable in terms of health service provision due to increased comorbidity, higher dependency and cognitive impairment. This review explored the literature to ascertain what reasonable adjustments are evident in acute care to support people with intellectual disability, ensuring they have fair access and utilisation of health services.DesignScoping review.SettingAcute care settings.MethodsFive databases were systematically searched to identify studies that reported on the implementation of reasonable adjustments. Authors worked in pairs to screen studies for inclusion, data were extracted and charted and findings were synthesised according to content and themes.ResultsOf the 7770 records identified, six studies were included in the review. The volume of evidence was influenced by specific inclusion criteria, and only papers that reported on the actual implementation of a reasonable adjustment within an acute care setting were included. Many papers reported on the concept of reasonable adjustment; however, few identified its applications in practice.ConclusionsThe scoping review highlights a lack of research on the practice and implementation of reasonable adjustments within acute care settings. There is a need for increased support, education and the provision of intellectual disability specialists across acute care settings.

scholarly journals Restricted visitation policies in acute care settings during the COVID-19 pandemic: a scoping review

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Karla D. Krewulak ◽  
Henry T. Stelfox ◽  
Sofia B. Ahmed ◽  
Melanie C. Anglin ◽  
...  
Keyword(s):  
Acute Care ◽  
Scoping Review ◽  
Healthcare Professionals ◽  
Case Series ◽  
Well Being ◽  
Primary Data ◽  
Cochrane Central Register ◽  
Negative Consequences ◽  
Primary Research ◽  
Acute Care Settings

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.

Screening for depression and anxiety among patients with acute coronary syndrome in acute care settings: a scoping review

2020 ◽  
Vol 18 (9) ◽  
pp. 1932-1969
Author(s):  
Tania S. Marin ◽  
Sandra Walsh ◽  
Nikki May ◽  
Martin Jones ◽  
Richard Gray ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Acute Care ◽  
Scoping Review ◽  
Depression And Anxiety ◽  
Coronary Syndrome ◽  
Acute Care Settings

scholarly journals The Role of High-Fidelity Team-Based Simulation in Acute Care Settings: A Systematic Review

2018 ◽  
Vol 04 (03) ◽  
pp. e136-e151 ◽  
Author(s):  
Sarah Armenia ◽  
Loka Thangamathesvaran ◽  
Akia Caine ◽  
Neil King ◽  
Anastasia Kunac ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Acute Care ◽  
Ad Hoc ◽  
Training Programs ◽  
High Fidelity ◽  
Acute Care Settings ◽  
Trauma Bay

Introduction High-fidelity team-based simulation has been identified as an effective way of teaching and evaluating both technical and nontechnical skills. Several studies have described the benefits of this modality in a variety of acute care settings, but a lack of standardized methodologies has resulted in heterogeneous findings. Few studies have characterized high fidelity simulation across a broad range of acute care settings and integrated the latest evidence on its educational and patient impact. Methods The MEDLINE, EMBASE, Cochrane Library, and PsycINFO databases were searched for empirical studies from the last 10 years, investigating high fidelity team-based simulation in surgical, trauma, and critical care training curricula. Results Seventeen studies were included. Interventions and evaluations were comprehensively characterized for each study and were discussed in the context of four overarching acute care settings: the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Conclusions The use of high-fidelity team-based simulation has expanded in acute care and is feasible and effective in a wide variety of specialized acute settings, including the emergency department/trauma bay, the operating room, the intensive care unit, and inpatient ad hoc resuscitation teams. Training programs have evolved to emphasize team-based, multidisciplinary education models and are often conducted in situ to maximize authenticity. In situ simulations have also provided the opportunity for system-level improvement and discussions of complex topics such as social hierarchy. There is limited evidence supporting the impact of simulation on patient outcomes, sustainability of simulation efforts, or cost-effectiveness of training programs. These areas warrant further research now that the scope of utilization across acute care settings has been characterized.

scholarly journals P123: Mental practice for technical skills training in emergency medicine: a scoping review

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S100-S100
Author(s):  
J. R. Riggs ◽  
C. Hicks
Keyword(s):  
Minimally Invasive ◽  
Skill Acquisition ◽  
Scoping Review ◽  
Technical Skills ◽  
Skills Training ◽  
Mental Practice ◽  
Cochrane Library ◽  
Task Completion ◽  
Procedural Skills ◽  
Movement Data

Introduction: Emergency physicians must achieve and maintain competence in numerous procedural skills, many of which are high stakes, time dependent, and used infrequently in clinical practice. Mental practice (MP) is the systematic use of mental imagery to see and feel an action in ones imagination without engaging in actual physical movement, and has been shown to enhance skill acquisition and performance in music and athletics. In this scoping review, we describe the utility and effectiveness of MP as a tool for procedural skill acquisition in medicine. Methods: An electronic search of MEDLINE, EMBASE, the Cochrane Library, CINAHL, PsycINFO, Open Grey, Conference Proceedings Index, ProQuest Dissertations and Theses and Google Scholar was conducted. Included studies evaluated MP for learning medically related technical skills using any method of mental training (script memorization, hypo-therapy, psychotherapy). Two independent reviewers screened articles for inclusion, and data was extracted using a standardized tool. Results: Our search returned 2028 results, of which 61 were eligible for inclusion. Forty-three studies evaluated MP interventions for technical skill development. Of these, 69.6% focused on minimally invasive surgical skills. The most common outcome measure was quantitative evaluation of skill via observer-scored checklist (69.6%). Other outcomes included stress, time to task completion, and haptic and movement data from surgical simulators. 82.6% of studies demonstrated a positive effect of MP on skill acquisition or performance. The quality of the trials was modest, and only 34.7% of published work provided clear detail on specific MP strategies. Conclusion: MP is an effective tool for procedural skills training. Areas outside of minimally invasive surgery are under-represented, and more data is needed on MP for rare or emergent procedures that typify emergency care. The minority of studies reviewed reported methods for developing and validating MP interventions in sufficient detail, a practice that should be adopted in future trials.

scholarly journals Examining non-technical skills for ad hoc resuscitation teams: a scoping review and taxonomy of team-related concepts

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
J. Colin Evans ◽  
M. Blair Evans ◽  
Meagan Slack ◽  
Michael Peddle ◽  
Lorelei Lingard
Keyword(s):  
Emergency Department ◽  
Network Analysis ◽  
Scoping Review ◽  
Ad Hoc ◽  
Descriptive Analysis ◽  
Citation Network ◽  
Technical Skills ◽  
Coherence Analysis ◽  
Citation Network Analysis ◽  
Prehospital Emergency

Abstract Background Non-technical skills (NTS) concepts from high-risk industries such as aviation have been enthusiastically applied to medical teams for decades. Yet it remains unclear whether—and how—these concepts impact resuscitation team performance. In the context of ad hoc teams in prehospital, emergency department, and trauma domains, even less is known about their relevance and impact. Methods This scoping review, guided by PRISMA-ScR and Arksey & O’Malley’s framework, included a systematic search across five databases, followed by article selection and extracting and synthesizing data. Articles were eligible for inclusion if they pertained to NTS for resuscitation teams performing in prehospital, emergency department, or trauma settings. Articles were subjected to descriptive analysis, coherence analysis, and citation network analysis. Results Sixty-one articles were included. Descriptive analysis identified fourteen unique non-technical skills. Coherence analysis revealed inconsistencies in both definition and measurement of various NTS constructs, while citation network analysis suggests parallel, disconnected scholarly conversations that foster discordance in their operationalization across domains. To reconcile these inconsistencies, we offer a taxonomy of non-technical skills for ad hoc resuscitation teams. Conclusion This scoping review presents a vigorous investigation into the literature pertaining to how NTS influence optimal resuscitation performance for ad hoc prehospital, emergency department, and trauma teams. Our proposed taxonomy offers a coherent foundation and shared vocabulary for future research and education efforts. Finally, we identify important limitations regarding the traditional measurement of NTS, which constrain our understanding of how and why these concepts support optimal performance in team resuscitation. Graphical abstract

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