Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests
Introduction
Extensive guidelines and algorithms exist on how to proceed during cardiopulmonary resuscitation [1], [2], [3]. However, cardiopulmonary resuscitation is a team endeavour and several health-care workers need to co-ordinate their activities to ensure optimal team performance. Thus, apart from medical knowledge and technical skills, human factors are likely to be relevant in the quality of cardiopulmonary resuscitation. There are only limited data on the significance of behavioural issues in cardiopulmonary resuscitation. Accordingly, the aim of the present study was to assess whether and how human factors affect the team performance during a simulated cardiac arrest.
Section snippets
Setting
The study was undertaken during an international congress for intensive care. Participants of the congress (nurses and physicians) were invited to attend a workshop called ‘medical simulation’. For each slot two nurses and one physician could register so that each simulation could be carried out with a team of three health-care workers. Registrations were considered in the order they were received (‘first come, first served’) and no attempt was made to balance the teams according to the level
Results
Sixteen simulations were carried out. All nurses that participated in the workshop had had special training in intensive care and were, at the time of the workshop, working in intensive care. All physicians participating were, at the time of the workshop, working in intensive care. However, only two out of 16 physicians had completed their training in intensive care while the remaining 14 were residents.
Only six out of the 16 teams were successful: five teams administered two countershocks
Discussion
In the present study we focused on the first crucial minutes of a cardiac arrest. Almost two thirds of teams composed of health-care professional currently working in intensive care failed to treat a witnessed cardiac arrest according to established guidelines [1], [2], [3]. Failure was associated with absence of leadership behaviour and the absence of explicit task distribution among team members.
Cardiopulmonary resuscitation is a team endeavour. Surprisingly, there is only little data on
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