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The Association Between Technical and Non-technical Skills in Real-life ALS Situations in a University Hospital

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ClinicalTrials.gov Identifier: NCT03017144
Recruitment Status : Completed
First Posted : January 11, 2017
Last Update Posted : January 6, 2020
Sponsor:
Information provided by (Responsible Party):
Turku University Hospital

Brief Summary:

Cardiac arrest is handled by cardiopulmonary resuscitation which is a time critical emergency situation. The actions during resuscitation are lead by international guidelines. Traditionally, the main focus of the training has been on medical knowledge and technical skills (TS). Nowadays non-technical skills (NTS), such as communication, teamwork behaviour, and leadership, are considered at least equally important.

The aim of this study is to evaluate both TS and NTS of the resuscitation team during real-life resuscitation situations using a validated assessment tool. The association between TS and NTS will be analyzed. Findings from this study may help to recognize the possible weaknesses and issues which could be improved by training. Hypothesis is that that TS are probably in a high level, but some improvement points of NTS are ought to be known better. Investigators hypothesis that the good NTS performance in resuscitation is accompanied by good TS performance.


Condition or disease
Cardiac Arrest

Detailed Description:

Background

Cardiac arrest is a time-critical emergency situation, which is treated by cardiopulmonary resuscitation (CPR). The actions during resuscitation are lead by international guidelines (Nolan et al 2010). Because of the relatively rare nature of cardiac arrests in many wards and clinics, regular resuscitation training is necessary.

During cardiopulmonary resuscitation and other sudden medical crisis situations, in addition to medical knowledge and technical skills (TS), also non-technical skills (NTS) are needed (Castelao et al 2011, Fletcher et al 2002, Helmreich et al 1999, Gaba et al 1998). NTS are behavioural elements which are ought to improve team performance. However, the importance of NTS has been demonstrated only in a simulated settings, not in a real life.

Objective, purpose, and hypothesis

The aim of this study is to evaluate the technical and especially non-technical skills of the resuscitation team during real-life resuscitation situations. Investigators hypothesis that good non-technical performance is related on good technical performance. Findings from this study may help to recognize the possible weaknesses and issues which could be improved by training. The hypothesis is that technical skills are probably on a high level, but some improvement points of non-technical skills are ought to be known better.

Design and Methods

Turku University Central Hospital lies in a Southwestern part of Finland, and provides medical services for 865 000 inhabitants. The target group of this study is the resuscitation team of the adult ICU of Turku University Central Hospital. This team consists of an ICU doctor (most commonly an anaesthesiologist specialized for intensive care), two ICU nurses, and one medical technician. These people are treating approximately 90 cardiac arrests per year, but this group also gets other alarms (like shortness of breath, unconscious patients and other acute situations). This ICU resuscitation team takes care of all resuscitation calls in the newer part of the Turku University Hospital, when the older parts of the hospital are taken care either by a resuscitation team from pediatric ICU or by prehospital emergency medical service system.

The data from 20 video-recorded real-life resuscitation situations treated by resuscitation team in Turku University Hospital will be collected and the overall NTS and TS score will be measured using a validated assessment tool. The association between the TS and NTS will be analyzed by statistical methods. In addition, after each recorded resuscitation situation, every member of the resuscitation team will be called by a phone. During the calls team members are asked to tell examples, what went well during the resuscitation, and what could have been done better. Based on these answers, inductive analysis will be made.

Two anaesthesiologists will evaluate the videos using the validated instrument tool.

Ethics

The study protocol was approved by the Ethics Committee of Turku University. All patients suffering from sudden cardiac arrest in Turku University newer hospital building area are considered eligible to the study regardless of the initial rhythm or presumed aetiology. Written information consent of patients is not needed, because the study is directed at resuscitation team performance. The patients are not identified at any phase of the study.

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Study Type : Observational
Actual Enrollment : 20 participants
Observational Model: Case-Only
Time Perspective: Prospective
Official Title: The Association Between Technical and Non-technical Skills in Real-life ALS Situations in a University Hospital
Study Start Date : June 2012
Actual Primary Completion Date : November 2014
Actual Study Completion Date : September 2018

Resource links provided by the National Library of Medicine





Primary Outcome Measures :
  1. To measure the association of the NTS and TS on one-another using validated assessment tool. [ Time Frame: one year ]

Secondary Outcome Measures :
  1. To evaluate the association between NTS and TS subgategories. [ Time Frame: one year ]


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
The target group of this study is the resuscitation team of the adult ICU of Turku University Central Hospital. This team consists of an ICU doctor (most commonly an anaesthesiologist specialized for intensive care), two ICU nurses and one medical technician.
Criteria

Inclusion Criteria:

  1. a doctor, a nurse, a paramedic or a medical technician working on adult ICU resuscitation team
  2. all the members of the ICU resuscitation team in the CPR-situation are volunteer to take part in the study

Exclusion Criteria:

1) if any member of the ICU resuscitation team in the CPR-situation refuse to be video recoded


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03017144


Sponsors and Collaborators
Turku University Hospital
Investigators
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Principal Investigator: Miretta Tommila, MD Turku University Hospital
Study Director: Sanna Salanterä, PhD, RN Vice Head of the Department of Nursing Science and Nurse Director at Turku University Hospital, Finland
Study Chair: Ville Peltonen, Lic.Med Turku University Hospital
Study Chair: Laura-Maria Peltonen, M.Sc. RN University of Turku, Finland, Nursing Science
Study Chair: Teemu Elomaa, Lic.Med Turku University Hospital
Study Chair: Jaana Elomaa, RN Turku University Hospital
Study Chair: Tomi Pappila, RN Vakka-Suomi Hospital Tyks, Finland
Study Chair: Sanna Hoppu, MD Tampere University Hospital, Finland
Study Chair: Eeva Hevonoja, RN University of Turku, Finland
Study Chair: Saija Hurme University of Turku, Finland
Study Chair: Katariina Perkonoja University of Turku, Finland
Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Turku University Hospital
ClinicalTrials.gov Identifier: NCT03017144    
Other Study ID Numbers: T70/2012
First Posted: January 11, 2017    Key Record Dates
Last Update Posted: January 6, 2020
Last Verified: January 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: Patients treated by cardiopulmonary resuscitation (CPR) in the videos can be recognized. Video material can not be shared due to patient privacy. Other data is possible to share.
Keywords provided by Turku University Hospital:
non-technical skills (NTS)
human factors
team work
Crew Resource Management / Crisis Resource Management (CRM)
technical skills (TS)
Cardiopulmonary resuscitation
Advanced cardiac life support
Additional relevant MeSH terms:
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Heart Arrest
Heart Diseases
Cardiovascular Diseases