Emergency obstetric simulation drills as a strategy to execute a multidisciplinary protocol with emphasis on safety culture evaluation, team synergy and team competency: A DNP project.

摘要

The aim of this Doctor of Nursing Practice Project was to implement emergency obstetric simulation to defend against patient safety risk linked to healthcare professional team dynamics in the care of obstetric patients as recommended by the Institute of Medicine (IOM), The Joint Commission (TJC) and the Quality and Safety Education for Nurses Initiative (QSEN). Team training is evidenced to reduce the mismanagement of emergency obstetric events by coaching providers in delivery of safe, effective and coordinated care during crises. The setting for this project was a hospital specializing in care of women and newborns. Hospitals, as the employers of healthcare professionals, have been uniquely positioned to be a training site for the multidisciplinary team.;Simulation training has been beneficial to healthcare agencies attempting to improve outcomes. Imogene King's Theory of Goal Attainment was utilized as the theoretical support for this project. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) method guided the project implementation.;Emergency obstetric simulation training was implemented to investigate the performance of a multidisciplinary team. A feasibility study utilizing a pretest and post-test method was used to evaluate the impact of simulation training on safety culture, and team synergy. The Agency for Healthcare Research & Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC), the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Teamwork Perceptions Questionnaire (T-TPQ) were used to collect data from nurses and physicians (N = 24). Team competency was assessed with the Multidisciplinary Competency Checklist (MCC). Exposure of the team to obstetric emergency simulation showed some impact on patient safety culture, although not statistically significant. Data assessing safety culture revealed that participants in this study as compared to database respondents ranked higher in most of the survey's culture of safety domains. Exposure to emergency obstetric simulation although not statistically significant in changing attitudes and perceptions about teamwork, may still coach behavior. Repetitive simulation and reflective debriefing may help the team to amend executions and to recall correct actions during actual obstetric crisis.