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Title: Improving resuscitation : the role of design and teamwork
Author: Walker, Susanna
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2013
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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.
Supervisor: Vincent, Charles ; Aggarwal, Rajesh Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral