A feasibility study of in situ simulation to evaluate the effect of training on teamwork and clinical performance in ward based nursing resuscitation teams

Abstract

Objective: To investigate feasible methods of using in situ simulation to evaluate teamwork and clinical performance in ward-­‐‑based nursing first responder resuscitation teams after the teams had participated in two different training programmes. Methods: This investigation involved a feasibility study using a randomised cluster trial in two general wards (one medical, one surgical) in an urban hospital in New Zealand. Ward clusters were randomised by coin toss into control or intervention groups. Both clusters participated in self-­‐‑directed e-­‐‑learning where the control package consisted of basic airway management, and use of a semiautomatic automated electrical defibrillator and basic life support algorithm. The intervention cluster completed the same package with the addition of a teamwork module. Results: Clusters were demographically well matched. The control cluster ward historically had a higher incidence of cardiac arrests (Control=68%, Intervention=32% of the total number of cardiac arrests). Clusters had similar scores for time from arrest to defibrillation (Control Mean=214.0s, Intervention M=217.0s) and accumulated chest compressions (Control, M=248.0s, Intervention, M=244.0s,) The intervention cluster was faster at commencing chest compressions (M=65.5s, Control M=82.5). The intervention cluster demonstrated higher total teamwork scores (M=12.0) than the control (M=8.5). Conclusions A randomised cluster study is a feasible way to evaluate and compare the performance of nursing first responder teams working in general hospital wards. Trends in the performance results suggested improved teamwork in the intervention cluster.