Purpose

The acquisition and interpretation of clinical results during resuscitations is common; however, this can delay critical clinical tasks, resulting in increased morbidity and mortality. This study aims to determine the impact of clinical result acquisition and interpretation by the team leader on critical task completion during simulated pediatric cardiac arrest before and after team training.

Methods

This is a secondary data analysis of video-recorded simulated resuscitation scenarios conducted during Teams4Kids (T4K) study (June 2011–January 2015); scenarios included cardiac arrest before and after team training. The scenario included either a scripted paper or a phone call delivery of results concurrently with a clinical transition to pulseless ventricular tachycardia. Descriptive statistics and non-parametric tests were used to compare team performance before and after training.

Results

Performance from 40 teams was analyzed. Although the time taken to initiate CPR and defibrillation varied depending on the type of interruption and whether the scenario was before or after team training, these findings were not significantly associated with the leader's behaviour [Kruskal–Wallis test (p > 0.05)]. An exact McNemar’s test determined no statistically significant difference in the proportion of leaders involved or not in interpreting results between and after the training (exact p value = 0.096).

Conclusions

Team training was successful in reducing time to perform key clinical tasks. Although team training modified the way leaders behaved toward the results, this behaviour change did not impact the time taken to start CPR or defibrillate. Further understanding the elements that influence time to critical clinical tasks provides guidance in designing future simulated educational activities, subsequently improving clinical team performance and patient outcomes.

中文翻译：

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模拟儿科心脏骤停期间临床结果采集和解释对任务绩效的影响：一项多中心观察研究

目的

复苏期间临床结果的获取和解释很常见；然而，这可能会延迟关键的临床任务，导致发病率和死亡率增加。本研究旨在确定团队领导在团队训练前后模拟儿科心脏骤停期间临床结果获取和解释对关键任务完成的影响。

方法

这是对Teams4Kids ( T4K ) 研究（2011 年 6 月至 2015 年 1 月）期间进行的录像模拟复苏场景的二次数据分析；情景包括团队训练前后的心脏骤停。该方案包括一份脚本文件或电话报告结果，同时临床过渡到无脉性室性心动过速。描述性统计和非参数测试用于比较训练前后的团队表现。

结果

分析了 40 个团队的表现。尽管启动 CPR 和除颤所需的时间取决于中断的类型以及情景是在团队训练之前还是之后，但这些发现与领导者的行为没有显着相关性 [Kruskal-Wallis 检验 ( p  > 0.05)]。精确的 McNemar 检验确定，在培训期间和之后，参与或不参与解释结果的领导者比例没有统计学上的显着差异（精确p值 = 0.096）。

结论

团队培训成功地减少了执行关键临床任务的时间。尽管团队培训改变了领导者对结果的行为方式，但这种行为改变并未影响开始 CPR 或除颤所需的时间。进一步了解影响关键临床任务时间的要素，可为设计未来的模拟教育活动提供指导，从而提高临床团队的绩效和患者的治疗效果。