BMJ quality & safety
-
BMJ quality & safety · Mar 2011
Evaluation of an instrument to measure teamwork in multidisciplinary critical care teams.
Teamwork failures contribute to adverse events causing harm to patients. Establishing and maintaining a team and managing the tasks are active processes. Medical education largely ignores teamwork skills. However, lack of robust instruments to measure teamwork limits evaluation of interventions to improve it. The authors aimed to develop and validate an instrument to measure teamwork behaviours. ⋯ The instrument performed well as an overall measure of team behaviour and reflected three dimensions of teamwork. Triangulation of information on the instrument, the factors and individual items will allow a methodical and informed approach to further development of the instrument. The ultimate goal is an instrument that can robustly evaluate interventions to improve team function in healthcare.
-
BMJ quality & safety · Mar 2011
Peri-operative medical emergency team activation in liver transplantation.
The medical emergency team (MET) system functions to promptly identify acutely ill patients at-risk for deterioration. Liver transplant (LT) patients are at-risk for serious post-operative complications. ⋯ LT patients with post-operative complications prompting MET activation had higher morbidity and mortality compared with controls; however, the MET may have been under-utilised and/or delayed. Further prospective multi-centre investigation is warranted.
-
BMJ quality & safety · Feb 2011
The impact of the medical emergency team on the resuscitation practice of critical care nurses.
Medical Emergency Teams (MET)/rapid response are replacing Cardiac Arrest teams in acute hospitals. There is a lack of knowledge about how Critical Care Nurses (CCNs), rostered on MET construct their responsibilities/roles. ⋯ 'Ongoing Assessment' and 'Re-evaluating Risk' occupied almost half of the MET nurses time, whereas 'Establishing Patient Acuity, the key activity in CA teams, occupied only 4%. These findings provide evidence of the roles of CCNs in the MET and suggest that education and training of MET nurses should support these roles.
-
To review studies on hospital doctors' handovers to identify the methods and main findings. ⋯ The handover literature does not fully identify where communication failures typically occur or influencing conditions, thus hampering the design of effective handover training and tools. A systematic analysis of all the stages of doctors' handovers is required.