scholarly journals The need for purposeful teaching, learning and assessment of crisis resource management principles and practices in the undergraduate pre-hospital emergency care curriculum: A narrative literature review

2021 ◽  
Vol 18 ◽  
Author(s):  
Mugsien Rowland ◽  
Anthonio Oladele Adefuye ◽  
Craig Vincent-Lambert
Keyword(s):  
Resource Management ◽  
Situation Awareness ◽  
Emergency Care ◽  
Care Setting ◽  
Clinical Skills ◽  
Hospital Setting ◽  
Technical Skills ◽  
Care Plan ◽  
Crisis Resource Management ◽  
Hospital Emergency

IntroductionTraditionally, undergraduate emergency medical care (EMC) training programs have, over the years, typically focussed on developing individuals with proficiency in clinical skills who can perform complex procedures in the act of administering safe and effective emergency care in the pre-hospital setting. A shortcoming of this training relates to the attention given to the soft skills needed to work efficiently in a team-based environment. Crisis resource management (CRM) is a structured, evidence-based approach to training that is designed to enhance teamwork performance in critical circumstances where the absence of coordinated teamwork could lead to undesired outcomes. MethodsA narrative review of GOOGLE SCHOLAR, MEDLINE, PUBMED, CINAHL as well as paramedic-specific journals was conducted. Articles were included if they examined the importance of CRM in pre-hospital emergency care; training undergraduate pre-hospital emergency care students on the principles and practices of CRM; and non-technical skills in pre-hospital emergency care. DiscussionResearchers found limited articles related to CRM and the pre-hospital emergency care setting. Our findings reveal that CRM focusses on addressing non-technical skills necessary for effective teamwork and that those identified to be relevant for effective teamwork in pre-hospital emergency care setting include situation awareness, decision-making, verbal communication, teamwork as well as leadership and followership skills. ConclusionEffective team management is a core element of expert practice in emergency medicine. When practised in conjunction with medical and technical expertise, CRM can reduce the incidence of clinical error and contribute to effective teamwork and the smooth running of a pre-hospital emergency care plan.

scholarly journals The identification of factors contributing to negative experiences of pre-hospital emergency care personnel in Johannesburg, South Africa

2021 ◽  
Vol 18 ◽  
Author(s):  
Andrew William Makkink ◽  
Christopher Owen Alexander Stein ◽  
Stevan Raynier Bruijns
Keyword(s):  
South Africa ◽  
Emergency Care ◽  
Descriptive Analysis ◽  
Hospital Setting ◽  
Data Communication ◽  
Hospital Emergency ◽  
Negative Experiences ◽  
Qualitative Descriptive ◽  
Formed Part ◽  
Patient Handover

Introduction The handover of a patient in the pre-hospital setting is different to other handover settings and therefore requires a different definition and description to that of other patient handover environments. Identifying those factors that affect the efficacy of handover could provide useful for formulating improvement strategies. Aim This research set out to describe the negative experiences of pre-hospital emergency care personnel handing over in the emergency centre in Johannesburg, South Africa, with a view to identifying potential areas for improvement. This paper reports on responses to an open-ended question that formed part of a purpose-designed, paper-based questionnaire that formed part of a mixed-methods study. Methods Data were collected from pre-hospital emergency care personnel within Johannesburg, South Africa. Responses from 140 participants were captured verbatim into Atlas.ti® for coding, analysis and interpretation using a qualitative descriptive methodology. Two themes were generated from a qualitative descriptive analysis of the data: communication barriers, and process barriers to emergency centre handover. These were confirmed by the categories and codes that made up these themes. Conclusion This study identifies some of the factors perceived by pre-hospital emergency care personnel to negatively affect emergency centre handover. It provides insights into how communication and process within the emergency centre have the potential to negatively impact emergency centre handover efficacy.

Crisis Resource Management and Patient Safety in Anesthesia Practice

2016 ◽  
Author(s):  
Amanda R. Burden ◽  
Jeffrey B. Cooper ◽  
David M. Gaba
Keyword(s):  
Patient Safety ◽  
Resource Management ◽  
Situation Awareness ◽  
Human Error ◽  
Medical Knowledge ◽  
Adverse Outcomes ◽  
Team Work ◽  
Crisis Resource Management ◽  
Behavioral Skills ◽  
Safety Issues

Crisis resource management (CRM) and patient safety are fundamental to the practice of anesthesiology. Human error and system failures continue to play a substantial role in preventable errors that lead to adverse outcomes or death. Many of these deaths are not the result of inadequate medical knowledge and skill, but occur because of problems involving communication and team management. CRM addresses these patient safety issues by addressing behavioral skills for critical events. These skills provide tools to help the leader manage the team and to help the team work together; they include calling for help, establishing situation awareness, using checklists, and communicating effectively. Effective strategies to teach these skills include the use of simulation for team training and Team STEPPS.

scholarly journals Out-of-hospital emergency care providers’ work and clinical skills in Finland: A follow-up study

2017 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
Riitta Mikkola ◽  
Mari Salminen-Tuomaala ◽  
Eija Paavilainen ◽  
Päivi Leikkola
Keyword(s):  
Educational Intervention ◽  
Emergency Care ◽  
Clinical Competence ◽  
Clinical Skills ◽  
Further Education ◽  
Care Providers ◽  
Hospital Emergency ◽  
Hospital District ◽  
Follow Up Study

Objective: This follow-up study is part of a larger study on emergency medical services. Its purpose was to describe emergency care providers’ perceptions of their work, its challenges and their clinical competence. The study aimed at producing knowledge of the perceived influence of an educational intervention, to be used in developing emergency care providers’ further and updating education.Methods: Data were collected from staff working in out-of-hospital emergency care of a hospital district in Finland using a questionnaire developed for this purpose. The results were analyzed statistically using SPSS for Windows 24.Results: Over 90% of the respondents found that their work was interesting and provided sufficient challenges. The majority were also interested in continuous professional development. After the educational intervention, respondents found the work somewhat more challenging and slightly more strenuous both physically and mentally compared to the first survey. Respondents more commonly reported that new capacities were required at work and they rated their practical skills lower than in the first survey. However, work in a multiprofessional environment was found less challenging. Over 70% of the respondents planned to have further education in the near future. They rated their clinical skills as good, but slightly lower compared to the first survey.Conclusions: The results regarding work, its challenges and self-rated clinical competence remained the same or were somewhat poorer after the educational intervention. The results help improve the education to meet the needs of emergency staff.

Workers' Clinical Skills at Out-of-Hospital Emergency Care

2015 ◽  
Vol 05 (06) ◽  
Author(s):  
Mari Salminen Tuomaala ◽  
Päivi Leikkola ◽  
Riitta Mikkola ◽  
Eija Paavilainen
Keyword(s):  
Emergency Care ◽  
Clinical Skills ◽  
Hospital Emergency

Are battlefield and prehospital trauma scenarios an effective educational tool to teach leadership and crisis resource management skills to undergraduate medical students?

2019 ◽  
Vol 166 (E) ◽  
pp. e34-e37
Author(s):  
Matt Ellington ◽  
S Farrukh
Keyword(s):  
Resource Management ◽  
Medical Students ◽  
Clinical Skills ◽  
Effective Means ◽  
Resource Utilisation ◽  
High Fidelity ◽  
Crisis Resource Management ◽  
Problem Solving Skills ◽  
Before And After ◽  
The Mean

IntroductionLeadership and crisis resource management (CRM) skills are important skills for doctors, however there is a recognised lack of undergraduate leadership education. There remains debate over how best to teach leadership and CRM skills, and poor leadership skills among clinicians are associated with adverse patient outcomes. We examined whether high-fidelity battlefield and prehospital scenarios can improve leadership and CRM skills.MethodThis was a prospective observational study with students self-reporting their leadership and CRM skills using the Ottawa Crisis Resource Management Global Ranking Scale (OCRMGRS) before and after completing the Cambridge University Emergency Medicine Society Battlefield and Pre-Hospital Trauma course. The course involves a mixture of small group tutorials and practical high-fidelity battlefield and prehospital trauma scenarios. Faculty also completed the OCRMGRS for the first and last candidates at the scenarios. The mean precourse versus mean postcourse score of the OCRMGRS was analysed using a two-tailed t-test.Results46 students completed paired OCRMGRS before and after the course. The mean precourse scores for each of the domains (leadership, communication skills, resource utilisation, problem solving skills and situational awareness) were calculated. There was a statistically significant (p<0.05) increase in both self-reported and faculty-reported scores across all domains, and the increase remained at 1-year follow-up.ConclusionsLeadership and CRM skills are important non-clinical skills for doctors, however there is debate over how best to teach them. High-fidelity battlefield and prehospital trauma scenarios are an effective means of teaching leadership and CRM skills to civilian medical students.

Do Technical Skills Correlate With Non-Technical Skills in Crisis Resource Management

2014 ◽  
Vol 58 (1) ◽  
pp. 15 ◽  
Author(s):  
N. Riem ◽  
S. Boet ◽  
M. D. Bould ◽  
W. Tavares ◽  
V. N. Naik
Keyword(s):  
Resource Management ◽  
Technical Skills ◽  
Crisis Resource Management

Maritime Pre-Hospital Emergency Care Primary Retrieval Team – Operational Considerations

2012 ◽  
Vol 98 (1) ◽  
pp. 16-18
Author(s):  
D Newman
Keyword(s):  
Emergency Response ◽  
Emergency Care ◽  
Clinical Skills ◽  
Medical Emergency ◽  
Nurse Specialist ◽  
Hospital Emergency ◽  
Retrieval Team ◽  
Response Team ◽  
And Training ◽  
Maritime Environment

AbstractThis article examines the non clinical skills and training required for effective maritime pre-hospital emergency care provision within a Role Two Afloat facility, allowing for a Primary Retrieval Team to be deployed in support of boarding operations. The provision of pre-hospital emergency care and sending a retrieval team forward has been trialled in various forms. In 2010 and 2011 a R2A team was deployed aboard RFA FORT VICTORIA. This included a Primary Retrieval Team consisting of an Emergency Nurse Specialist, a Medical Assistant which can be enhanced when required by an Emergency Care or Anaesthetic Consultant. This differs from the land operations support provided by the airborne Medical Emergency Response Team (MERT) as the maritime environment requires a bespoke solution for casualty retrieval as the method of deployment and the type of casualties and their locations may be more varied, requiring greater flexibility of approach.

ANALISIS HUBUNGAN KARAKTERISTIK PERAWAT TERHADAP KEMAMPUAN NON TEKNIS DALAM PELAKSANAAN KEGAWATAN NEONATAL

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Ni Luh Diah Ayu Sita Dewi ◽  
Ali Haedar, Ahsan
Keyword(s):  
Decision Making ◽  
Situation Awareness ◽  
Work Experience ◽  
Clinical Skills ◽  
Sampling Technique ◽  
Technical Skills ◽  
P Value ◽  
Soft Skill ◽  
Cross Sectional ◽  
Purposive Sampling

Abstract : The ratio of neonatal mortality rate increases with the number of births. The quality of the emergency of neonatal treatment with adequate facilities supported capacity of health personnel in the management of neonatal emergency is very important. Emergency nurse competence consists of: cognitive, clinical skills, and non-technical skills. Non-technical skills or soft skills, namely: communication, teamwork, situation awareness, leadership and decision-making and stress management. They still lack the training and learning curriculum non technical capability in the handling of the emergency of neonatal into inaccuracies in implementing the emergency of neonatal handling competence. Characteristics demographic is very influential in the implementation of the competence and performance of the emergency of neonatal nurses. The aim of this research is to analyze the characteristics of nurses to non technical capabilities in the implementation of the emergency of neonatal health center PONED. The design was cross-sectional sampling using purposive sampling technique. The number of study subjects consisted of 153 respondents. Instruments used in the form Closed Ended instrument. Based on the test results with Cross Table p value p> 0.05 characteristics of the training and continuing education, long work experience, and employment status of nurses is not related to the ability of non-technical nurses. Characteristics middle adulthood, the sex of male nurses (p <0.05) related to the non-technical abilities of nurses though not significant. Characteristics of respondents with education level S1 nursing significantly related to non technical capabilities of nurses in the decision-making capability variables. The conclusion of this study is characteristic of primary education nursing nurses correlate significantly on the ability of non-technical in neonatal emergency handler. Nursing implications of this research are expected to be upgraded non-technical ability to repair competence in the handling of the emergency of neonatal nurses.Keywords : demographics, skills, neonatal, non-technical, emergency, nurse Abstrak : Rasio angka mortalitas neonatal meningkat seiring peningkatan jumlah kelahiran. Kualitas penanganan kegawatan neonatal dengan fasilitas memadai ditunjang  kemampuan tenaga kesehatan dalam penanganan kegawatan  neonatal sangat penting. Kompetensi perawat kegawatan terdiri dari : kognitif, keterampilan klinis, dan keterampilan non teknis. Keterampilan non teknis atau soft skill yaitu :komunikasi, kerjasama tim, kesadaran situasi, kepemimpinan, pengambilan keputusan, dan manajemen stres. Masih minimnya pelatihan dan kurikulum pembelajaran kemampuan non teknis dalam penanganan kegawatan neonatal menjadi ketimpangan dalam melaksanakan kompetensi penanganan kegawatan neonatal. Karakteristik demografi sangat berpengaruh dalam pelaksanaan kompetensi dan performa perawat kegawatan neonatal. Tujuan dari penelitian ini menganalisis karakteristik perawat terhadap kemampuan non teknis dalam pelaksanaan kegawatan neonatal di Puskesmas PONED. Desain yang digunakan adalah cross sectional dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian terdiri dari 153 responden. Instrumen yang digunakan berupa Closed Ended Instrumen. Berdasarkan hasil uji dengan Cross Table nilai p value p>0.05 karakteristik pelatihan dan pendidikan lanjut, lama pengalaman kerja, dan status kepegawaian perawat tidak berhubungan terhadap kemampuan non teknis perawat. Karakteristik usia dewasa pertengahan, jenis kelamin laki-laki perawat (p<0,05) berhubungan terhadap kemampuan non teknis perawat walau tidak signifikan. Karakteristik responden dengan tingkat pendidikan S1 keperawatan berhubungan secara signifikan terhadap kemampuan non teknis perawat pada variabel  kemampuan pengambilan keputusan. Kesimpulan dalam penelitian ini adalah karakteristik  pendidikan dasar keperawatan perawat berhubungan secara signifikan terhadap kemampuan non teknis dalam penanganan kegawatan neonatal. Implikasi keperawatan dalam penelitian ini adalah diharapkan kemampuan non teknis ditingkatkan untuk perbaikan kompetensi perawat dalam penanganan kegawatan neonatal. Kata kunci : demografi, ketrampilan, neonatal, non teknis, kegawatan, perawat

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