Resuscitation is the process medical teams use in an attempt to save a patient’s life
when they have suffered a cardiopulmonary arrest. It is a stressful, time-pressured
procedure, and unfortunately is often futile. Care of a patient in the emergency
setting is particularly prone to errors and adverse events for a variety of reasons.
These include the time-pressured decision making, increased rate of patient
interventions, and the fact that teams are “assembled” by the emergency call that
may have never worked together, or even met each other, before. Recent analysis of
incident reports specifically from resuscitation attempts suggests that the majority of
incidents relate to issues with the resuscitation team, problems related to human
performance, and incidents relating to malfunctioning or absent equipment.
One of the aims of this thesis is to look at ways to address these issues, and reduce
rates of adverse events and critical incidents at resuscitation attempts. I will
specifically look at the areas of non-technical teamworking skills, team training with
environmental risk assessment, and the design of ergonomic equipment.
In Chapter 4 I will describe the process of development and evaluation of a tool to
assess non-technical teamworking skills in resuscitation teams. When this tool was
initially developed, no other tools had been published. However, another tool has
subsequently been made available, therefore in Chapter 5 I will compare our tool,
OSCAR, with this other tool, called TEAM. In Chapter 6 I describe the process of in situ simulation for resuscitation training. I
organised resuscitation team simulations as part of a training programme, and
gathered participant feedback on the training. I also describe some of the
unanticipated benefits of this training, such as risk assessment of the ward
environment.
In Chapters 7 and 8 I describe two studies that were undertaken to evaluate the
newly designed Resus:Station. Specifically I assessed its use during simulated
cardiac arrest scenarios, and when nursing staff performed a stock check of the
trolley.