학술논문

Improving patient's intensive care admission through multidisciplinary simulation‐based crisis resource management: A qualitative study.
Document Type
Article
Source
Journal of Clinical Nursing (John Wiley & Sons, Inc.). Oct2023, Vol. 32 Issue 19/20, p7530-7542. 13p.
Subject
*EDUCATION of physicians
*NURSING education
*OCCUPATIONAL roles
*TEAMS in the workplace
*RESEARCH
*HEALTH services administration
*NURSES' attitudes
*RESEARCH methodology
*PATIENTS
*SIMULATION methods in education
*PHYSICIANS' attitudes
*INTERVIEWING
*PATIENT-centered care
*HOSPITAL admission & discharge
*EXPERIENCE
*QUALITATIVE research
*PHENOMENOLOGY
*CRITICAL care medicine
*HEALTH care teams
*QUALITY assurance
*COMMUNICATION
*INTERPROFESSIONAL relations
*RESEARCH funding
*THEMATIC analysis
*MEDICAL practice
*JUDGMENT sampling
*DATA analysis software
*HEALTH planning
*PATIENT safety
*REFLECTION (Philosophy)
Language
ISSN
0962-1067
Abstract
Aim: To explore nurses' and physicians' experiences of simulation‐based training in a crisis resource management quality improvement intervention on intensive care admission. Background: Quantitative studies have documented that staffs' non‐technical skills are improved after simulation‐based training in crisis resource management interventions. Experienced‐based consensus led to development of a quality improvement intervention based on principles of crisis resource management and tested in simulation‐based training to enhance staffs' non‐technical skills. However, the impact on staff is unexplored, leaving little understanding of the relationship between simulation‐based training in crisis resource management interventions and changes in non‐technical skills. Design: A qualitative study with a hermeneutical approach. Methods: Data consisted of semi‐structured interviews with physicians (n = 5) and nurses (n = 15) with maximum variation in work experience. Data were collected 3 months after implementation and analysed using thematic analysis. The COREQ guideline was applied. Results: The analysis revealed three themes: prioritising core clinical activities and patient centredness; transition into practice; and reflection on patient safety. These themes reflected staff's experiences of the intervention and implementation process, which evolved through prioritising core clinical activities that facilitated the transition into clinical practice and staff's reflection on patient safety. Conclusions: Prioritising core clinical activities were facilitated by clear communication, predefined roles and better teamwork. Transition into practice stimulated professional growth through feedback. Reflection on patient safety created a new understanding on how a new structure of intensive care admission could be implemented. Collectively, this indicated a joint understanding of admissions. Implications for Practice: Findings enables health care professionals to understand how the intervention can contribute to improve quality of care in management of intensive care admission. Improving non‐technical skills are vital in high‐quality admissions, which supported a structured process and a collaborative professional standard of admissions. Patient and Public Contribution: None. [ABSTRACT FROM AUTHOR]