alert 2014-new-ambati2
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The effect of random leader role assignment
on task and team performance during
resuscitationShashikanth Reddy Ambati
Northshore-LIJ (New York, NY) Pediatric Critical Care Fellow
INSPIRE @ IMSH 2014: San Francisco, CA,USA
International Network for Simulation-based Pediatric Innovation, Research and Education
• Human factors influence quality and outcomes of CPR.1
• One of the most consistent human factor limitations is failure to identify leader
International Network for Simulation-based Pediatric Innovation, Research and Education
Background
Lack of a defined leader role delays care and impairs communication in resuscitation.2
International Network for Simulation-based Pediatric Innovation, Research and Education
Background
1. Identified leader role will improve the effectiveness of medical response and team performance
2. Profession of the leader(Physician or Nurse) will affect team performance
International Network for Simulation-based Pediatric Innovation, Research and Education
Hypotheses
• P : Resuscitation caregivers
• I : Identified leader role (physician or
nurse)
• C: No Identified leader role
• O: Time to BVM; Time to Compressions;
Time to IV medications; Team
Performance3
International Network for Simulation-based Pediatric Innovation, Research and Education
PICO Question
• Scenario: Infant in respiratory distress.
• Randomization: 4-person resuscitation team to Intervention or Control
• Intervention- identified leader
• Control- no identified leader
International Network for Simulation-based Pediatric Innovation, Research and Education
Approach / Design
• Time line: q1 month simulations × 24
months@ local sim center
• The scenarios will be video recorded.
• Data collection: observed times, scores
on team performance scale3
International Network for Simulation-based Pediatric Innovation, Research and Education
Approach/Design
1. Primary Outcome: Time to BVM
2. Secondary Outcomes: Time to
compressions, time to IV medications
and team performance
International Network for Simulation-based Pediatric Innovation, Research and Education
Outcomes
1. Feed back on the design.
2. Looking to make into a multicenter
study.
3. For possible granting agencies.
International Network for Simulation-based Pediatric Innovation, Research and Education
3 Questions to improve study
• Shashikanth Reddy Ambati
• CCMC, North Shore LIJ Hospital
International Network for Simulation-based Pediatric Innovation, Research and Education
Contact Information
References1. S.Hunziker, F.Tschan. NK Semmer, Howell, S.Marsch. Human factors in resuscitation: Lessons learned from simulator studies. J Emerg Trauma
Shock. 2010 Oct; 3(4):389-94.
2. Fernandez Castelao E, Russo SG, Riethmüller M, Boos M. Effects of team coordination during cardiopulmonary resuscitation: A systematic review of the literature. J Crit Care. 2013 Aug;28(4):504- 21.
3. Nicholas Allen Hamilton, Alicia N. Kieninger, etal. Video Review Using Reliable Evaluation Metric Improves Team Function in High-Fidelity Simulated Trauma Resuscitation. Journal of Surgical Education volume 69/Number 3 May/June 2012.
4. Elizabeth A. Hunt, MD, Allen R. Walker, MD, Donald H. Shaffner, MD, Marlene R. Miller, MD, Peter J. Pronovost, MD. Simulation of In-Hospital Pediatric Medical Emergencies and Cardiopulmonary Arrests: Highlighting the Importance of the First 5 Minutes. Pediatrics. 2008 Jan; 121(1):e34-4.