The use of a checklist improves anaesthesiologists’ technical and non-technical performance for simulated malignant hyperthermia management

Hardy, Jean-Baptiste; Gouin, Antoine; Compère, Vincent; Veber, Benoît; Bertrand, Denis

doi:10.1016/j.accpm.2017.07.009

Cited by 30 publications

(31 citation statements)

References 25 publications

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“…Checklists have been shown to reduce intubation-related complications19 and may facilitate decision-making under stress20 21 The checklist in our study was designed to be read aloud by the airway nurse to the airway doctor during preoxygenation with the aim of ensuring a thorough preparation of the team, equipment and patient, for every ED RSI. Beyond the benefits of a fastidious approach to preparation for RSI, our staff report that the now familiar process achieves a calmer approach to laryngoscopy and empowers the airway nurse to be more involved in discussions around the airway plan and the rescue techniques that will be most appropriate for the individual patient.…”

Section: Discussionmentioning

confidence: 99%

Impact of a targeted bundle of audit with tailored education and an intubation checklist to improve airway management in the emergency department: an integrated time series analysis

et al. 2020

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BackgroundEndotracheal intubation (ETI) is a commonly performed but potentially high-risk procedure in the emergency department (ED). Requiring more than one attempt at intubation has been shown to increase adverse events and interventions improving first-attempt success rate should be identified to make ETI in the ED safer. We introduced and examined the effect of a targeted bundle of airway initiatives on first-attempt success and adverse events associated with ETI.MethodsThis prospective, interventional cohort study was conducted over a 2-year period at an Australian Major Trauma Centre. An online airway registry was established at the inception of the study to collect information related to all intubations. After 6 months, we introduced a bundle of initiatives including monthly audit, monthly airway management education and an airway management checklist. A time series analysis model was used to compare standard practice (ie, first 6 months) to the postintervention period.ResultsThere were 526 patients, 369 in the intervention group and 157 in the preintervention comparator group. A total of 573 intubation attempts were performed. There was a significant improvement in first-attempt success rates between preintervention and postintervention groups (88.5% vs 94.6%, relative risk 1.07; 95% CI 1.00 to 1.14, p=0.014). After the introduction of the intervention the first-attempt success rate increased significantly, by 13.4% (p=0.006) in the first month, followed by a significant increase in the monthly trend (relative to the preintervention trend) of 1.71% (p<0.001). The rate of adverse events were similar preintervention and postintervention (hypoxia 8.3% vs 8.9% (p=0.81); hypotension 8.3% vs 7.0% (p=0.62); any complication 27.4% vs 23.6% (p=0.35)).ConclusionsThis bundle of airway management initiatives was associated with significant improvement in the first-attempt success rate of ETI. The introduction of a regular education programme based on the audit of a dedicated airway registry, combined with a periprocedure checklist is a worthwhile ED quality improvement initiative.

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Section: Discussionmentioning

confidence: 99%

Impact of a targeted bundle of audit with tailored education and an intubation checklist to improve airway management in the emergency department: an integrated time series analysis

et al. 2020

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“…The SSC consists of a set of questions with structured answers that should be asked and answered before induction of anaesthesia, before skin incision, and before the patient leaves the operating theatre. In addition, several studies presented checklists aiming to better manage critical events [221,223,233]. Only one study on SSC was conducted outside the surgery department/operating theatre (i.e.…”

Section: Structuring Toolsmentioning

confidence: 99%

Interventions to improve team effectiveness within health care: a systematic review of the past decade

2020

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Background: A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved. An updated overview is therefore required, and it will focus on all possible team interventions without restrictions to a type of intervention, setting, or research design. Objectives: To review the literature from the past decade on interventions with the goal of improving team effectiveness within healthcare organizations and identify the "evidence base" levels of the research. Methods: Seven major databases were systematically searched for relevant articles published between 2008 and July 2018. Of the original search yield of 6025 studies, 297 studies met the inclusion criteria according to three independent authors and were subsequently included for analysis. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence. Results: Three types of interventions were distinguished: (1) Training, which is subdivided into training that is based on predefined principles (i.e. CRM: crew resource management and TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety), on a specific method (i.e. simulation), or on general team training. (2) Tools covers tools that structure (i.e. SBAR: Situation, Background, Assessment, and Recommendation, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger (through monitoring and feedback) teamwork. (3) Organizational (re)design is about (re)designing structures to stimulate team processes and team functioning. (4) A programme is a combination of the previous types. The majority of studies evaluated a training focused on the (acute) hospital care setting. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements. Conclusion: Over the last decade, the number of studies on team interventions has increased exponentially. At the same time, research tends to focus on certain interventions, settings, and/or outcomes. Principle-based training (i.e. CRM and TeamSTEPPS) and simulation-based training seem to provide the greatest opportunities for reaching the improvement goals in team functioning.

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“…In France, the development of CAs is continuing to grow since they were first made available (in French) in 2016 by the French Society of Anaesthesia and Intensive Care Medicine (SFAR) [14,19]. e number of presentations at meetings and French publications about CAs is also increasing [20].…”

Section: Discussionmentioning

confidence: 99%

Use of Cognitive Aids: Results from a National Survey among Anaesthesia Providers in France and Canada

Blanié

Kurrek

Gorse

et al. 2020

Anesthesiology Research and Practice

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Introduction. The use of cognitive aids (CAs) during critical events is thought to be useful. However, whether CAs are known and used by French and Canadian anaesthesia providers is not clear. Methods. A survey was emailed to French and Canadian anaesthesia providers in 2017 through their respective national societies. It consisted of 23 questions about the participants’ demographics and their knowledge, use, and impact of CAs. A second survey was sent to French simulation centres. Results. 912 responses were recorded in France and 278 in Canada (overall response rate: 7% and 11%, respectively). Among the respondents, 700/899 in France (78%) versus 249/273 (91%) in Canada were familiar with the concept of cognitive dysfunction during a crisis and 501/893 (56%) in France versus 250/271 (92%) in Canada knew the concept of CAs. Amongst those respondents who knew about CAs, 189/492 (38%) in France versus 108/244 (44%) in Canada stated that they had already used a CA in real life and 225/493 (45%) in France versus 126/245 (51%) in Canada had received training in their use. Simulation was the principal modality for training in 150/225 (67%) of cases in France versus 47/126 (37%) in Canada. Among the 28/50 French simulation centres which responded (2018 January), 27 organised sessions in anaesthesia and 22 used CAs. Conclusion. CAs were better known in Canada than in France, but their actual use in real life was low in both countries. Simulation appears to play a potentially important role training anaesthesia providers in the use of CAs.

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The use of a checklist improves anaesthesiologists’ technical and non-technical performance for simulated malignant hyperthermia management

Cited by 30 publications

References 25 publications

Impact of a targeted bundle of audit with tailored education and an intubation checklist to improve airway management in the emergency department: an integrated time series analysis

Impact of a targeted bundle of audit with tailored education and an intubation checklist to improve airway management in the emergency department: an integrated time series analysis

Interventions to improve team effectiveness within health care: a systematic review of the past decade

Use of Cognitive Aids: Results from a National Survey among Anaesthesia Providers in France and Canada

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