DOCSLIB.ORG

Teamwork During Cardiopulmonary Resuscitations at a Rural

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Teamwork During Cardiopulmonary Resuscitations at a Rural TEAMWORK DURING CARDIOPULMONARY RESUSCITATIONS AT A RURAL MINNESOTA HOSPITAL A Dissertation Submitted to the Graduate Faculty of the North Dakota State University of Agriculture and Applied Science By Kayla Dale Dascher In Partial Fulfillment of the Requirements for the Degree of DOCTOR OF NURSING PRACTICE Major Department: Nursing March 2015 Fargo, North Dakota North Dakota State University Graduate School Title Teamwork During Cardiopulmonary Resuscitations At A Rural Minnesota Hospital By Kayla Dale Dascher The Supervisory Committee certifies that this disquisition complies with North Dakota State University’s regulations and meets the accepted standards for the degree of DOCTOR OF NURSING PRACTICE SUPERVISORY COMMITTEE: Dr. Mykell Barnacle Chair Dr. Tina Lundeen Professor Kara Falk Dr. Daniel Klenow Approved: March 25, 2015 Dr. Carla Gross Date Department Chair ABSTRACT Cardiac arrest is a major public health problem affecting thousands of individuals each year in both out-of-hospital and in-hospital settings (Sutton, Nadkarni, & Abella, 2012). In 2012 nearly 383,000 out-of-hospital sudden cardiac arrests occurred and approximately 209,000 cardiac arrests occurred within a hospital (American Heart Association, 2012). Survival rates from cardiac arrest are improving, however overall rates of survival are still low (American Heart Association, 2012). The purpose of this project was to enhance the teamwork, knowledge, and technical skills of all individuals involved in cardiopulmonary resuscitations at the project site. Expectations of the project were to (1) enhance cardiopulmonary resuscitation knowledge by providing evidence- based resources to team members, (2) clearly delineate roles of team members during resuscitations, and (3) develop a continuing education plan that will ensure the maintenance of quality cardiac resuscitations. A survey to assess the needs of the cardiac resuscitation team members was distributed to all providers at the project site as well as all staff registered nurses, pharmacists, respiratory therapists, nurse anesthetists, and hospital unit coordinators. The survey results identified the nurses’ perception that the providers lack leadership skills during resuscitations. Many survey responses noted confusion about the role of each individual during resuscitations. Nurses felt lack of confidence in knowledge of medications, as well as mixing and titration of medications. Based on feedback from the survey, six mock resuscitation/simulations were facilitated utilizing four scenarios that were developed. Following each mock resuscitation/simulation, a debriefing occurred utilizing a debriefing tool. A post mock resuscitation survey was administered at the completion of the project. Eleven surveys were returned. Results of the iii project were overall positive. Evidence based resources were developed and utilized by providers and nursing during both mock and actual resuscitations. Posters were developed and placed in the emergency department that clearly delineated each participant’s role. A continuing education plan based upon feedback from a post resuscitation survey was developed. The continuing education plan includes having mock resuscitations/simulations once per month at various times of the day to accommodate all staff. iv ACKNOWLEDGMENTS This project involved the assistance of many individuals. I would like to acknowledge the chair of my committee, Dr. Mykell Barnacle. Dr. Barnacle was a wonderful resource and without her patience and guidance this would not have been possible. I would also like to recognize the other members in my committee: Dr. Tina Lundeen, Professor Kara Falk, Dr. Daniel Klenow, and Roxanna Holper. This project wouldn’t have been successful without the support and participation from the organization that participated in this endeavor, Mayo Clinic Health System in Lake City. Specifically Maura McCabe, nursing education specialist, and Roxanna Holper were instrumental in making this project successful. v TABLE OF CONTENTS ABSTRACT .................................................................................................................................. iii ACKNOWLEDGMENTS ............................................................................................................... v CHAPTER 1. BACKGROUND AND SIGNIFICANCE ............................................................... 1 Introduction ................................................................................................................................. 1 Statement of the Problem ............................................................................................................ 2 Purpose of Clinical Dissertation Project ...................................................................................... 3 CHAPTER 2. LITERATURE REVIEW AND THEORETICAL FRAMEWORK ....................... 4 Team and Teamwork ................................................................................................................... 4 Leadership ................................................................................................................................... 6 Simulation.................................................................................................................................... 9 Debriefing .................................................................................................................................. 16 Theoretical Framework ............................................................................................................. 18 CHAPTER 3. PROJECT DESIGN ............................................................................................... 21 Project Implementation ............................................................................................................. 21 Institutional Review Board Approval ........................................................................................ 23 Data Collection .......................................................................................................................... 24 CHAPTER 4. EVALUATION METHODS USING THE PLAN-DO-STUDY-ACT CYCLE ... 25 Instruments ................................................................................................................................ 25 Plan ............................................................................................................................................ 25 Do .............................................................................................................................................. 26 Study .......................................................................................................................................... 27 Act ............................................................................................................................................. 27 CHAPTER 5. RESULTS ............................................................................................................... 29 Presentation of Findings ............................................................................................................ 29 vi Objective One ............................................................................................................................ 29 Objective Two ........................................................................................................................... 29 Objective Three ......................................................................................................................... 30 CHAPTER 6. DISCUSSION AND RECOMMENDATIONS ..................................................... 31 Interpretation of Results ............................................................................................................ 31 Objective One ............................................................................................................................ 31 Objective Two ........................................................................................................................... 32 Objective Three ......................................................................................................................... 33 Limitations of Project ................................................................................................................ 34 Recommendations ..................................................................................................................... 35 Implications for Practice ............................................................................................................ 36 Implications for Future Research .............................................................................................. 37 Application to Other Nurse Practitioner Roles .......................................................................... 37 REFERENCES .............................................................................................................................. 39 APPENDIX A. NDSU IRB LETTER OF APPROVAL ............................................................... 47 APPENDIX B. PROJECT LETTER CONSENT ......................................................................... 48 APPENDIX C. MOCK RESUSUCITATION/SIMULATION SCENARIOS ............................. 49 APPENDIX D. PROVIDER RESOURCES ................................................................................. 53 APPENDIX E. DEBRIEFING TOOL .........................................................................................
Load more

Recommended publications
  • Agility Factors and Their Impact on Product Development Performance
    INTERNATIONAL DESIGN CONFERENCE - DESIGN 2018 https://doi.org/10.21278/idc.2018.0236 AGILITY FACTORS AND THEIR IMPACT ON PRODUCT DEVELOPMENT PERFORMANCE E. Rebentisch, E. C. Conforto, G. Schuh, M. Riesener, J. Kantelberg, D. C. Amaral and S. Januszek Abstract Agile product development is popular but still not well understood beyond its methodological implications. This paper reports an identification of agility factors enabling teams to make and communicate decisions more quickly in product development. On this basis, a quantitative System Dynamics (SD) model is developed and analyzed to explore the impact of the identified agility factors on the product development performance. The results show that both methodological and team factors do not only influence agility but can also significantly improve the project completion time and product quality. Keywords: product development, agile development, teamwork, system dynamics, collaborative design 1. Introduction Highly dynamic market opportunities and rising global competition have led to a shift from seller’s to buyer’s market. As a consequence, today’s companies and organizations need to be more flexible and reactive towards changes and perceptive towards new market opportunities to remain competitive and innovative (Schuh and Bender, 2012; Schwab et al., 2016). Product development organizations are also affected, as they are consistently exposed to a high degree of uncertainty in terms of changing customer requirements or other instable market conditions (Hull et al., 2017). That is why companies and their product development teams need to move from an anticipatory to adaptive style of developing new products, especially in a highly technological and innovative business world (Highsmith, 2010; MacCormack, 2013; Schuh et al., 2017).
    [Show full text]
  • Teamwork in the Service of Health HUGH R
    Officia Mth of PUBLIC HEALTH Official Monthly Publication of the American Public Health Association, Inc. Volume 44 November, 1954 Number II Teamwork in the Service of Health HUGH R. LEAVELL, M.D., Dr.P.H., F.A.P.H.A. We all realize that an organized ap- Here is a classic summary of what proach is needed to deal effectively with we mean by public health "team- work," and a very pertinent appli- the complex problems and the diverse cation to our own Association. population groups we meet in our daily work. We are concerned with the total community rather than placing our em- All of us have experience in team- phasis on the individual, as the private work and we know how important it is practitioner does. in getting a job done. As an introduc- We tend to stress the preventive tion to our discussion, may we consider rather than the curative aspects of total first some of the things we in public health service. At the same time we health have in common which provide recognize that it is impossible to draw the oneness of objective so essential to a sharp line dividing prevention from good teamwork. cure. Curing one phase of a disease All of us are involved in some type of may so interrupt its natural history that organized community activity. This is complications and aftereffects are pre- the essential element that differentiates vented. public health from other forms of pre- Though we come from many basic ventive medicine, according to Profes- professions, we tend to think of our- sor Winslow's world-famous definition, selves as members of the public health which I recently found to be just about profession-a sort of "E pluribus as well known in Latin America and unum"! As professional people, and be- in Asia as in North America.
    [Show full text]
  • Topic 4: Being an Effective Team Player
    Topic 4: Being an effective team player Why teamwork is an essential element Learning objectives: of patient safety 1 • understand the importance of teamwork in Effective teamwork in health-care delivery can health-care; have an immediate and positive impact on patient • know how to be an effective team player; safety [1]. The importance of effective teams in • recognize you will be a member of a number health care is increasing due to factors such as: (i) of health-care teams as a medical students. the increasing complexity and specialization of care; (ii) increasing co-morbidities; (iii) increasing Learning outcomes: knowledge and chronic disease; (iv) global workforce shortages; performance and (v) safe working hours initiatives. Paul M. Schyve, MD, senior vice president of the Joint What students need to know (knowledge Commission has observed, “Our challenge … is requirements) 3 4 not whether we will deliver care in teams but rather Knowledge requirements in this how well we will deliver care in teams.”[2] module include a general understanding of: • the different types of teams in health care; A typical example of complex care involving • the characteristics of effective teams; multiple teams would be a pregnant woman with • the role of the patient in the team. diabetes who develops a pulmonary embolus— her medical care team includes: an obstetrician, What students need to do (performance an endocrinologist and a respiratory physician. requirements) 5 The doctors and nurses looking after her will be Use the following teamwork principles to different during the day compared to at night and promote effective health care including: on the weekend.
    [Show full text]
  • Benefits of Multidisciplinary Teamwork in the Management of Breast Cancer
    Breast Cancer: Targets and Therapy Dovepress open access to scientific and medical research Open Access Full Text Article REVIEW Benefits of multidisciplinary teamwork in the management of breast cancer Cath Taylor1 Abstract: The widespread introduction of multidisciplinary team (MDT)-work for breast Amanda Shewbridge2 cancer management has in part evolved due to the increasing complexity of diagnostic and Jenny Harris1 treatment decision-making. An MDT approach aims to bring together the range of special- James S Green3,4 ists required to discuss and agree treatment recommendations and ongoing management for individual patients. MDTs are resource-intensive yet we lack strong (randomized controlled 1Florence Nightingale School of Nursing and Midwifery, King’s College trial) evidence of their effectiveness. Clinical consensus is generally favorable on the benefits London, London UK; 2Breast Cancer of effective specialist MDT-work. Many studies have shown the benefits of receiving treatment Services, Guy’s and St Thomas’ from a specialist center, and evidence continues to accrue from comparative studies of clinical NHS Foundation Trust, London, UK; 3Department of Urology, Barts Health benefits of an MDT approach, including improved survival. Patients’ views of the MDT model 4 For personal use only. NHS Trust, London, UK; Department of decision-making (and in particular its impact on involvement in decisions about their care) of Health and Social Care, London have been under-researched. Barriers to effective teamwork and poor decision-making include South Bank University, London, UK excessive caseload, low attendance at meetings, lack of leadership, poor communication, role ambiguity, and failure to consider patients’ holistic needs. Breast cancer nurses have a key role in relation to assessing holistic needs, and their specialist contribution has also been asso- ciated with improved patient experience and quality of life.
    [Show full text]
  • The Path to the Next Normal
    The path to the next normal Leading with resolve through the coronavirus pandemic May 2020 Cover image: © Cultura RF/Getty Images Copyright © 2020 McKinsey & Company. All rights reserved. This publication is not intended to be used as the basis for trading in the shares of any company or for undertaking any other complex or significant financial transaction without consulting appropriate professional advisers. No part of this publication may be copied or redistributed in any form without the prior written consent of McKinsey & Company. The path to the next normal Leading with resolve through the coronavirus pandemic May 2020 Introduction On March 11, 2020, the World Health Organization formally declared COVID-19 a pandemic, underscoring the precipitous global uncertainty that had plunged lives and livelihoods into a still-unfolding crisis. Just two months later, daily reports of outbreaks—and of waxing and waning infection and mortality rates— continue to heighten anxiety, stir grief, and cast into question the contours of our collective social and economic future. Never in modern history have countries had to ask citizens around the world to stay home, curb travel, and maintain physical distance to preserve the health of families, colleagues, neighbors, and friends. And never have we seen job loss spike so fast, nor the threat of economic distress loom so large. In this unprecedented reality, we are also witnessing the beginnings of a dramatic restructuring of the social and economic order—the emergence of a new era that we view as the “next normal.” Dialogue and debate have only just begun on the shape this next normal will take.
    [Show full text]
  • How Interdisciplinary Teamwork Contributes to Psychosocial Cancer Support
    CORECopyeditor: Timi S. Garduque Metadata, citation and similar papers at core.ac.uk Provided by Ghent University Academic Bibliography Copyright B 2018 Wolters Kluwer Health, Inc. All rights reserved. Michiel Daem, MSc, RN AQ1 Mathieu Verbrugghe, PhD, MSc Wim Schrauwen, MSc Silvian Leroux, MSc, RN Ann van Hecke, PhD, MSc, RN Maria Grypdonck, PhD, MSc, RN How Interdisciplinary Teamwork Contributes to Psychosocial Cancer Support KEY WORDS Background: The organization of psychosocial care is rather complex, and its Cancer provision diverse. Access is affected by the acceptance and attitude of patients and Collaboration professional caregivers toward psychosocial care. Objectives: The aims of this Distress study were to examine when patients with cancer experience quality psychosocial Help care and to identify circumstances in collaboration that contribute to Interdisciplinary patient-perceived positive psychosocial care. Methods: This study used a Multidisciplinary qualitative design in which semistructured interviews were conducted with patients, Nursing hospital workers, and primary health professionals. Results: Psychosocial care is Oncology often requested but also refused by patients with cancer. Based on this discrepancy, Psycho-oncology a distinction is made between psychosocial support and psychosocial interventions. Psychology Psychosocial support aims to reduce the chaos in patients " lives caused by cancer Psychosocial and is not shunned by patients. Psychosocial interventions comprise the formal care Qualitative research offered in response to psychosocial problems. Numerous patients are reluctant to use Support psychosocial interventions, which are often provided by psychologists. Teamwork Conclusion: Psychosocial care aims to assist patients in bearing the difficulties of cancer and its treatment. Patients prefer informal support, given often in conjunction with physical care.
    [Show full text]
  • 417 Copyright © 2020 by Academic Publishing House Researcher S.R.O
    European Journal of Contemporary Education, 2020, 9(2) Copyright © 2020 by Academic Publishing House Researcher s.r.o. All rights reserved. Published in the Slovak Republic European Journal of Contemporary Education E-ISSN 2305-6746 2020, 9(2): 417-433 DOI: 10.13187/ejced.2020.2.417 www.ejournal1.com WARNING! Article copyright. Copying, reproduction, distribution, republication (in whole or in part), or otherwise commercial use of the violation of the author(s) rights will be pursued on the basis of international legislation. Using the hyperlinks to the article is not considered a violation of copyright. Characteristics of the Project-Based Teamwork in the Case of Developing a Smart Application in a Digital Educational Environment Elena V. Soboleva a, Nikita L. Karavaev a , * a Vyatka State University, Kirov, Russian Federation Abstract The study is aimed at solving a problem generated by the necessity to change the organizational forms of digital learning to prepare graduates who meet the requirements of today’s labor market; who are equipped with teamwork skills and skills of project-management under uncertainty which are especially relevant nowadays. The purpose of the study is to provide a theoretical foundation for and experimentally verify the effectiveness of involving students in project teamwork on designing smart applications by means of modern digital technologies; project teamwork activities allow developing the skills and abilities characteristic of a strong research culture necessary for making future discoveries in science and technology. The research methods are the analysis and generalization of psychological and pedagogical literature, of development strategies and education theories; mathematical methods of statistics, psychodiagnostics and survey methods.
    [Show full text]
  • Achieving Quality Through Teamwork
    Achieving Quality Through Teamwork High value is manifested in the positive feelings Quality and Teamwork or pride one feels in owning that particular product or having experienced outstanding Over many years, the industrial world has created a service. This feeling is then transmitted to other lot of mystique around the concept of quality, how to consumers by “word of mouth.” achieve it, and how to maintain it. There have been many strategies, programs, and processes invented for • Quality is a mindset. In order for our many different industries on how to address this issue. customers to perceive our product or service as In order to attain the state of highest quality in our high quality, it must start with those who produce products, we must understand what quality really is: it. Each employee must understand both the • Quality is a perception more than a reality. process and the philosophy behind the product In order for a product or service to be ranked or service in order to consistently meet the high on quality surveys, it must be thought to be customer’s expectations. of high quality by a large number of people. Getting your employees to adopt a quality mindset is When this perception of quality is widely the real key to producing high quality products and accepted by others, it puts the product or service services. Employees must feel a sense of ownership. above its competition in such a way that the That is, they must feel responsible for the outcome of consumer will not only prefer it over similar anything connected with the product or service.
    [Show full text]
  • 9780802419149-TOC-CH1.Pdf
    CONTENTS Introduction 9 1. Building Kindness 15 2. Increasing Gratitude 31 3. Cultivating Love 45 4. Seeking Compromise 63 5. Choosing Forgiveness 81 6. Improving Communication 101 7. Enhancing Trust 117 8. Developing Compassion 133 9. Increasing Patience 151 10. Getting Organized 169 11. Creating Fun 183 12. Building Connection 197 Epilogue: Home Maintenance 215 Home Life Inspection Quiz 221 Acknowledgments 227 Notes 229 About the Authors 233 DIY Guide to Building a Family that Lasts F.indd 7 4/11/19 11:00 AM Home Improvement Goal: Demolish selfishness. Home Improvement Tool: Build kindness. DIY Guide to Building a Family that Lasts F.indd 14 4/11/19 11:00 AM Chapter 1 BUILDING KINDNESS Share the load . the laundry load, that is! #yougottalaugh GARY: Early on, I wasn’t SHANNON: My kids considerate enough of won’t let me not consider Karolyn’s needs. Thankfully, their needs. They’re sweet, she was (and is) persistent but very verbal . and in letting me know. very assertive. #Consider #Consider me way more me out for the count at considerate now than when bedtime! we started out! “THAT’S MINE!” “You’re in my space.” “We don’t ever do what I want to do.” Do you frequently hear comments like these around your home? Are they typically said with an angry or critical attitude? If you answered yes to these questions, you’re not alone! DIY Guide to Building a Family that Lasts F.indd 15 4/11/19 11:00 AM The DIY Guide to Building a Family That Lasts Comments and attitudes such as these suggest that your family, like many others, deals with selfishness.
    [Show full text]
  • Effective Teamwork Transcript Episode 7 – Startup Survival Podcast
    Effective Teamwork Transcript Episode 7 – Startup Survival Podcast By Peter Harrington July 2020 Speaker 1 (00:05): Hi and welcome to this startup survival podcast. All about effective teamwork. My name's Peter Harrington. And in this episode, I am joined by two startup entrepreneurs who will be sharing their recent experience of managing a team through this challenging crisis. Prepare yourself for some invaluable teamworking takeaways, lessons and insights. Speaker 1 (00:34): For startups who want to grow or scale, building an effective team is a critical part of the challenge. Whether employees or contractors, people must be recruited, selected, trained, managed, and placed within a team where they can hopefully maximize that promise and potential. It all sounds quite simple. Unfortunately, in practice, the simple can quickly turn complex, and that's why a dose of easy to digest theory is a welcome tonic. Grounded theory helps to straighten out the tangled threads that can often strangle effective teamwork. Meaningful theory makes the complex, simpler and shines a much needed light on key issues. Speaker 1 (01:22): Back in the early nineties, my first startup was growing and I remember asking a teamwork trainer to come and help us make sense of our brave new evolving world. Our team was made up of different people with different backgrounds and different personalities. Greetings over, the trainer Margaret, sat us in a circle and immediately introduced a four stage theoretical process for team productivity, namely forming, storming, norming, and performing. If you are unfamiliar with this process, let me shed some light because these catchy words are particularly pertinent at this moment in time.
    [Show full text]
  • Teamwork Secures Its First-Ever Investment of $70 Million from Bregal Milestone to Turbo-Charge Growth
    Teamwork secures its first-ever investment of $70 million from Bregal Milestone to turbo-charge growth Teamwork sets sights on becoming the world’s undisputed leading Project Management SaaS for Client Services companies Cork, Ireland; London, United Kingdom, 6 July 2021 – Teamwork, a leading global Project Management SaaS solution focused on Client Services companies, has today announced its first-ever fundraise of $70 million from Bregal Milestone, a leading European technology growth capital firm. Trusted by more than 20,000 teams across 170 countries, Teamwork has revolutionized how companies manage their daily workflows for improved automation, productivity, and profitability. Teamwork provides an intuitive SaaS platform for Client Services companies, helping them to track, manage, and invoice their projects as well as providing a full suite of tightly integrated solutions such as helpdesk, collaboration, knowledge sharing, and customer relationship management add-ons; enabling Teamwork to be the ‘one-stop-shop’ practice management solution for business owners. Teamwork has offices in 5 countries and a global team of 270 employees. Teamwork will work closely with Bregal Milestone’s in-house value creation team, Milestone Performance Partners, to further accelerate Teamwork’s growth and invest in various product development initiatives to delight even more customers globally. A privately-owned company that has never received any external funding from investors before today, Teamwork is a true Irish success story. Entrepreneurs Peter Coppinger and Daniel Mackey founded Teamwork in 2007 and grew the business profitably since its inception. The duo were also the recipients of the EY Entrepreneur of the Year award. Maples Group and Torch Partners advised Teamwork on the transaction and Matheson, PricewaterhouseCoopers and Code & Co.
    [Show full text]
  • Culturally Competent Practice and Teamwork Results in Positive
    June 2012 Newsletter Vol 12 A project funded through MPCWIC and developed by CYFD’s Protective Services Culturally Competent Practice and This month’s focus on Teamwork Results in Positive Out- Piñon values: Vision: Culturally Compe- comes for a Child in Taos County Children and youth tent Practice: in New Mexico live During the May 2012 Quality Assurance Review in in a family environ- Taos, a case was reviewed that provided an excellent We understand, respect ment free from example of culturally competent best practice, effec- and serve children, youth abuse and neglect. and families within the tive communication and teamwork. The efforts of the context of their own investigator, the permanency worker, placement, the children’s court attorney and the relative foster par- family rules, traditions, Mission: history and culture. ent have resulted in positive outcomes for the child, increased placement stability and improved cultural We serve children, connections. youth and fami- See story (right) lies by protecting to learn how this value was recently Upon the child’s entry into foster care, the assigned children and youth applied in Taos Co. investigator did a comprehensive assessment and from abuse and determined that the child was of Native American neglect; pursuing Next month’s ancestry and identified a maternal grandmother for timely permanency value: Trustworthy and placement. Agency staff coordinated across county and; promoting Accountable lines with the Sandoval office to complete an Initial well-being. Relative Assessment and placed the child with her grandmother as her first and only placement. Standards work- groups’ next task: Not only did this teamwork ensure that the child did not have to experience a change review policies/ in placement, it guaranteed that the child was placed in accordance with ICWA place- procedures ment preferences.
    [Show full text]