Exploring young Australian adults’ asthma management to develop an educational video
- Authors: Coombs, Nicole , Allen, Louise , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Laszcyk, Jacki , Giannis, Anita , Hopmans, Ruben , Bullock, Shane , Waller, Susan , McKenna, Lisa , Peck, Blake
- Date: 2018
- Type: Text , Journal article
- Relation: Health Education Journal Vol. 77, no. 2 (2018), p. 179-189
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- Description: Objective: This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group. Design: Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video. Setting: Participants were students at two universities in the state of Victoria, Australia. Method: In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed. Results: A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial maternal reliance; ‘Health literacy: family and Dr Google’, denoting low health literacy levels with passive reluctant involvement in personal health management; and ‘Information gathering – one size doesn’t fit all’ – in the form of the need for immediate gratification and resource variety. Based on interviewees’ words and terminology, we designed an interactive branching educational video for YouTube portraying a young person (an actor) during an asthma flare-up. Conclusion: Young adults lacked insight into their condition and even after moving away from home, relied on Google searches and/or parents’ advice. To enhance health-seeking behaviours, interactive programmes with smartphone access may be valuable. Our open access programme Help Trent Vent provides an educational resource for young people with asthma and for health education teams, to reinforce asthma knowledge. © 2017, © The Author(s) 2017.
Improving the non-technical skills of hospital medical emergency teams : The Team Emergency Assessment Measure (TEAM™)
- Authors: Cant, Robyn , Porter, Joanne , Cooper, Simon J. , Roberts, Kate , Wilson, Ian , Gartside, Christopher
- Date: 2016
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 28, no. 6 (2016), p. 641-646
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- Description: Objectives: This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Methods: Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. Results: In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P < 0.001), with 38.4% of shared variance. RNs praised the instrument as it initiated staff reflection and debriefing discussions around performance improvement. Conclusion: Non-technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Measuring teamwork performance: Validity testing of the Team Emergency Assessment Measure (TEAM) with clinical resuscitation teams
- Authors: Cooper, Simon J. , Cant, Robyn , Connell, Cliff , Sims, Lyndall , Porter, Joanne , Symmons, Mark , Nestel, Debra , Liaw, Sok Ying
- Date: 2016
- Type: Text , Journal article
- Relation: Resuscitation Vol. 101, no. (2016), p. 97-101
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- Description: AimTo test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED). BackgroundNon-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes. MethodsA quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM. ResultsMost rated events were for full cardiac resuscitation (43%) with 3–15 team members present for an average of 45min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p=<0.001), respectively, and a single ‘teamwork’ construct was identified. Non-technical skills overall were good but leadership was rated notably lower than task and teamwork performance indicating a need for leadership training. ConclusionThe TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing.
The impact of web-based and face-to-face simulation on patient deterioration and patient safety : Protocol for a multi-site multi-method design
- Authors: Cooper, Simon J. , Kinsman, Leigh , Chung, Catherine , Cant, Robyn , Boyle, Jayne , Bull, Loretta , Cameron, Amanda , Connell, Cliff , Kim, Jeong-Ah , McInnes, Denise , McKay, Angela , Nankervis, Katrina , Penz, Erika , Rotter, Thomas
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Health Services Research Vol. 16, no. 1 (2016), p. 1-8
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- Description: Background: There are international concerns in relation to the management of patient deterioration which has led to a body of evidence known as the 'failure to rescue' literature. Nursing staff are known to miss cues of deterioration and often fail to call for assistance. Medical Emergency Teams (Rapid Response Teams) do improve the management of acutely deteriorating patients, but first responders need the requisite skills to impact on patient safety. Methods/design: In this study we aim to address these issues in a mixed methods interventional trial with the objective of measuring and comparing the cost and clinical impact of face-to-face and web-based simulation programs on the management of patient deterioration and related patient outcomes. The education programs, known as 'FIRST2ACT', have been found to have an impact on education and will be tested in four hospitals in the State of Victoria, Australia. Nursing staff will be trained in primary (the first 8 min) responses to emergencies in two medical wards using a face-to-face approach and in two medical wards using a web-based version FIRST2ACTWeb. The impact of these interventions will be determined through quantitative and qualitative approaches, cost analyses and patient notes review (time series analyses) to measure quality of care and patient outcomes. Discussion: In this 18 month study it is hypothesised that both simulation programs will improve the detection and management of deteriorating patients but that the web-based program will have lower total costs. The study will also add to our overall understanding of the utility of simulation approaches in the preparation of nurses working in hospital wards. (ACTRN12616000468426, retrospectively registered 8.4.2016). © 2016 The Author(s).
Measuring the non-technical skills of medical emergency teams: an update on validity and reliability of Team Emergency Assessment Measure (Team).
- Authors: Cant, Robyn , Cooper, Simon J.
- Date: 2014
- Type: Text , Journal article
- Relation: Resuscitation Vol. 85, no. (2014), p. 31-33
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- Description: Medical emergency team performance including non-technical skills, is receiving increased attention due to the influences on patient safety. The Team Emergency Assessment Measure View the MathML source was developed to enable standardized performance assessment and structured team debriefing. From several studies, the View the MathML source has demonstrated a substantial body of normative data confirming its validity and reliability. This includes high uni-dimensional validity, significant subscale relationships between Teamwork and Leadership and between Teamwork and Task Management (p < 0.001), a Cronbach alpha of 0.92 and adequate construct validity. The tool has potential for team training to improve team's non-technical performance. Further testing is required in ‘real’ clinical settings.
Managing patient deterioration: assessing teamwork and individual performance
- Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Missen, Karen , Sparkes, Louise , McConnell-Henry, Tracy , Endacott, Ruth
- Date: 2013
- Type: Text , Journal article
- Relation: Emergency Medicine Journal Vol. 30, no. 5 (2013), p.
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- Description: Objective To assess the ability of rural Australian nurse teams to manage deteriorating patients. Methods This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Results Knowledge in relation to patient deterioration management varied (mean 63%, range 27–100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17–83%, SD 14.03) with significantly higher levels in younger participants (r=−0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Conclusion Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.