Teamwork in obstetric critical care

Abstract

Whether seeing a patient in the ambulatory clinic environment, performing a delivery or managing a critically ill patient, obstetric care is a team activity. Failures in teamwork and communication are among the leading causes of adverse obstetric events, accounting for over 70% of sentinel events according to the Joint Commission. Effective, efficient and safe care requires good teamwork. Although nurses, doctors and healthcare staff who work in critical care environments are extremely well trained and competent medically, they have not traditionally been trained in how to work well as part of a team. Given the complexity and acuity of critical care medicine, which often relies on more than one medical team, teamwork skills are essential. This chapter discusses the history and importance of teamwork in high-reliability fields, reviews key concepts and skills in teamwork, and discusses approaches to training and working in teams.

Uterine Atony: Management Strategies

“…Sufficient notice is necessary to the recipient unit to allow adequate time for assembly of equipment and monitors as well as allocation of staff and presence of intensivist on site for rapid assessment upon arrival. In an unstable patient, the minimum team for transfer should consist of a trained and skilled doctor who is able to re-intubate a ventilated patient and to detect any change in condition, a nurse and two assistants to manoeuvre the bed (Guise & Segel, 2008;Haupt et al, 2003;Price et al, 2009;Price et al, 2008).…”

“…This enables immediate detection and early management of complications, hence, may prevent or lower morbidity and mortality. (Guise & Segel, 2008;Martin & Foley 2006;Plaat & Wray, 2008) Nursing the critically ill is a complex job. Their main role is to provide continuous close monitoring of the patient.…”

“…They are able to analyze patient's clinical changes, anticipate possible complications leading to shorter recovery period and better emotional support for both the patient and family members. (Price et al, 2008;Simpson & Barker, 2008;Guise & Segel 2008) Physiotherapist plays an important role in reducing overall morbidity of the patient. Postoperative physiotherapy enables a faster recovery phase, lower risk of ventilation-associated sepsis or pneumonia, and a shorter ICU stay.…”

Enhancing Virtual Environment-Based Surgical Teamwork Training With Non-Verbal Communication

“…Research indicates that failure in communication occurs in 30% of team exchanges and that one third to 70% of these failures result in situations putting the patient's life at risk. (Lingard et al, 2004;Guise and Segel, 2008). To increase patient safety, training and improvement of communication among team members has to be an important aspect of clinical simulation.…”

Trabalho em equipe de enfermagem: interação, conflito e ação interprofissional em hospital especializado

“…Esses benefícios são descritos como: diminuição dos custos e racionalização dos serviços, redução da duplicidade de ações, melhor comunicação entre profissionais, e entre profissionais e paciente, maior satisfação no emprego e bem-estar psicológico entre os profissionais, desenvolvimento de abordagens e soluções inovadoras para problemas complexos, melhora no desempenho profissional individual, continuidade do cuidado com melhores resultados clínicos, diminuição do tempo de permanência em internações, aumento da segurança do paciente, diminuição de erros médicos e iatrogenias, aumento da satisfação do paciente, família e cuidador (ALLISON, 2007;GUISE;SEGEL, 2008;HOFFMAN et al, 2008;KEARNEY, 2008;MILLS;NEILY;DUNN, 2008;PATEL;PRATT;PATEL, 2008;POOCHIKIAN-SARKISSIAN et al, 2008;RETCHIN, 2008;RODRIGUEZ et al, 2007;SALAS et al, 2008;).…”