alert 2014-new-ambati2

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

• shashiambati@gmail.com

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.