Team Resource Management in Surgery and Endoscopy

Background: In the field of acute medicine, the vast majority of riskfuland prognosis-relevant procedures are not performed by individuals butrather by (ad hoc) teams. Method: Findings in scientific papersimpressively show the causes of medical mishaps and severe errors aswell as the lasting effectiveness of training in team resource formats(Team Resource Management, TRM) in order to combat these chains oferrors in acute medicine. Results: The analysis of the literature since2003 and the numerous findings regarding the research of medical errorsshow that more than 70% of the severe and prognosis-relevant mishapsand complications can be assigned to the medical providers themselves.The implementation and continuous advancement of patient safety in thefield of human factors as well as the application of TRM-relatedprinciples requires a sound and widely accepted safety culture as abasis. Conclusions: TRM training measures and non-punitive criticalincident reporting systems effectively contribute to an increasing andmeasurable improvement of the safety culture in acute medicine

Practical examination of bystanders performing Basic Life Support in Germany: a prospective manikin study

<p>Abstract</p> <p>Background</p> <p>In an out-of-hospital emergency situation bystander intervention is essential for a sufficient functioning of the chain of rescue. The basic measures of cardiopulmonary resuscitation (Basic Life Support – BLS) by lay people are therefore definitely part of an effective emergency service of a patient needing resuscitation. Relevant knowledge is provided to the public by various course conceptions. The learning success concerning a one day first aid course ("LSM" course in Germany) has not been much investigated in the past. We investigated to what extent lay people could perform BLS correctly in a standardised manikin scenario. An aim of this study was to show how course repetitions affected success in performing BLS.</p> <p>Methods</p> <p>The "LSM course" was carried out in a standardised manner. We tested prospectively 100 participants in two groups (<b>Group 1: </b>Participants with previous attendance of a BLS course; <b>Group 2: </b>Participants with no previous attendance of a BLS course) in their practical abilities in BLS after the course. Success parameter was the correct performance of BLS in accordance with the current ERC guidelines.</p> <p>Results</p> <p>Twenty-two (22%) of the 100 investigated participants obtained satisfactory results in the practical performance of BLS. Participants with repeated participation in BLS obtained significantly better results (<b>Group 1: </b>32.7% vs. <b>Group 2: </b>10.4%; p < 0.01) than course participants with no relevant previous knowledge.</p> <p>Conclusion</p> <p>Only 22% of the investigated participants at the end of a "LSM course" were able to perform BLS satisfactorily according to the ERC guidelines. Participants who had previously attended comparable courses obtained significantly better results in the practical test. Through regular repetitions it seems to be possible to achieve, at least on the manikin, an improvement of the results in bystander resuscitation and, consequently, a better patient outcome. To validate this hypothesis further investigations are recommended by specialised societies.</p

Team Resource Management in Surgery and Endoscopy

Background: In the field of acute medicine, the vast majority of riskfuland prognosis-relevant procedures are not performed by individuals butrather by (ad hoc) teams. Method: Findings in scientific papersimpressively show the causes of medical mishaps and severe errors aswell as the lasting effectiveness of training in team resource formats(Team Resource Management, TRM) in order to combat these chains oferrors in acute medicine. Results: The analysis of the literature since2003 and the numerous findings regarding the research of medical errorsshow that more than 70% of the severe and prognosis-relevant mishapsand complications can be assigned to the medical providers themselves.The implementation and continuous advancement of patient safety in thefield of human factors as well as the application of TRM-relatedprinciples requires a sound and widely accepted safety culture as abasis. Conclusions: TRM training measures and non-punitive criticalincident reporting systems effectively contribute to an increasing andmeasurable improvement of the safety culture in acute medicine