Quản lý nguồn lực đội ngũ trong Khoa hồi sức tích cực: nhu cầu thay đổi văn hóa

Annals of Intensive Care - Tập 2 - Trang 1-5 - 2012
Marck HTM Haerkens1, Donald H Jenkins2, Johannes G van der Hoeven3
1Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, NK ‘s-Hertogenbosch, The Netherlands
2Division of Trauma and Critical Care, Mayo Clinic, Rochester, USA
3Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

Tóm tắt

Chăm sóc hồi sức thường xuyên dẫn đến những tổn hại không mong muốn cho bệnh nhân và thống kê dường như không có dấu hiệu cải thiện. Môi trường Khoa hồi sức đặc biệt khắc nghiệt đối với những sai lầm do tính chất đa ngành, cấp bách của việc chăm sóc và sự dễ tổn thương của bệnh nhân. Các yếu tố con người chiếm đa số các sự kiện bất lợi và do đó, một môi trường an toàn là điều cần thiết. Bài báo này xem xét các tài liệu hiện có về đào tạo dựa trên hàng không được gọi là Quản lý Nguồn lực Đội ngũ (CRM) và thảo luận về việc áp dụng nó trong y học hồi sức. CRM tập trung vào làm việc nhóm, quản lý mối đe dọa và lỗi lầm cùng với việc thảo luận không có trách nhiệm về những sai lầm của con người. Mặc dù bằng chứng vẫn còn hạn chế, các tác giả coi CRM là một công cụ hứa hẹn cho sự thay đổi văn hóa trong môi trường Khoa hồi sức, nếu được hỗ trợ bởi lãnh đạo và có chương trình theo dõi được thiết kế hợp lý.

Từ khóa

#Khoa hồi sức #Quản lý Nguồn lực Đội ngũ #an toàn bệnh nhân #thay đổi văn hóa #quản lý sai lầm.

Tài liệu tham khảo

Kohn LT, Corrigan JM, Donaldson MS: To err is human: building a safer health system. National Academy Press, Washington; 2000. Wagner C, Zegers M, De Bruijne MC: Patient safety: unintended and potentially preventable adverse events within surgical specializations. Ned Tijdschr Geneeskd 2009, 153: 327–333. Kievits F, van Maanen H: Kosten ziekenhuisfouten becijferd [Hospital costs accounted for]. Ned Tijdschr Geneeskd 2009, 153: 476. Dekker S: Doctors are more dangerous than gun owners: a rejoinder to error counting. Lund University School of Aviation Tech report, Ljungbyhed, Sweden; 2006:2006. de Vries EN, Prins HA, Crolla RMPH, et al.: Effect of a Comprehensive Surgical Safety System on Patient Outcomes. N Engl J Med 2010, 363: 1928–1937. 10.1056/NEJMsa0911535 Donchin Y, Gopher D, Olin M, et al.: A look into the nature and causes of human errors in the intensive care unit. Crit Care Med 1995, 23: 294–300. 10.1097/00003246-199502000-00015 Cook TM: Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 2: intensive care and emergency departments. Br J Anaesth 2011, 106: 632–642. 10.1093/bja/aer059 Foster AJ, Worthington JR, Hawken S, et al.: Using prospective clinical surveillance to identify adverse events in hospital. BMJ Qual Saf 2011, 20: 756–763. 10.1136/bmjqs.2010.048694 Boyle D, O’Connell D, Platt FW, Albert RK: Disclosing errors and adverse events in the intensive care unit. Crit Care Med 2006, 5: 1532–1537. Bion JF, Abrusci T, Hibbert P: Human factors in the management of the critically ill patient. Br J Anaesth 2010, 105: 26–33. 10.1093/bja/aeq126 Reason J: Understanding adverse events: human factors. Qual Health Care 1995, 4: 80–89. 10.1136/qshc.4.2.80 Paine LA, Rosenstein BJ, Sexton JB, et al.: Assessing and improving safety culture throughout an academic medical centre: A prospective cohort study. Postgrad Med J 2011, 87: 428–435. 10.1136/pgmj.2009.039347rep Colla JB, Bracken AC, Kinney LM, et al.: Measuring patient safety climate: a review of surveys. Qual Saf Health Care 2005, 14: 364–366. 10.1136/qshc.2005.014217 Cooper MD, Phillips RA: Exploratory analysis of the safety climate and safety behavior relationship. J Saf Res 2004, 35: 497–512. 10.1016/j.jsr.2004.08.004 Nielsen KJ, Mikkelsen KL: Predictive factors for self-reported occupational injuries at 3 manufacturing plants. Saf Sci Monit 2007, 2: 1–9. Sexton JB, Berenholtz SM, Goeschel CA, et al.: Assessing and improving safety climate in a large cohort of intensive care units. Crit Care Med 2011, 5: 934–939. Dekker S: The re-invention of human error. Lund university School of Aviation Tech report, Ljungbyhed, Sweden; 2002–01:2002. Dismukes RK, Berman B: Checklists and monitoring in the cockpit: why crucial defenses sometimes fail. NASA-Ames Research Center Moffet Field. Technical Memorandum NASA/TM, California; 2010:2010–216396. Schaeffer H, Helmreich R: The operating room management attitudes questionnaire (ORMAQ). NASA/University of Texas Technical Report, Austin, Texas; 1993:93–98. Legemate DA: Safety first. Ned Tijdschr Geneeskd 2009, 153: 313. Brindley PG: Patient safety and acute care medicine: lessons from the future, insights from the past. Crit Care 2010, 14: 217. 10.1186/cc8858 Cooper GE, White MD, Lauber JK: Resource management on the flightdeck: proceedings of a NASA/industry workshop. NASA-Ames Research Center Moffett Field, CA, USA; 1980:2120. (NASA Conference Publication No.CP-2120) van Schijndel RJM S, Burchardi H: Bench-to-bedside review: Leadership and conflict management in the intensive care unit. Crit Care 2007, 11: 234. 10.1186/cc6108 Garrouste-Orgeas M: Selected Medical Errors in the Intensive Care Unit. Am J Respir Crit Care Med 2010, 181: 134–142. 10.1164/rccm.200812-1820OC Eisen LA, Savel RH: What went right: Lessons for the intensivist from the crew of US Airways Flight 1549. Chest 2009, 136: 910–917. 10.1378/chest.09-0377 Stockwell DC, Slonim AD: Quality and Safety in the Intensive Care Unit. J Intensive Care Med 2006, 21: 199–210. 10.1177/0885066606287079 Salas E, DiazGranados D, Klein C: Does team training improve team performance? Human Factors 2008, 6: 903–933. Ricci MA, Brumsted JR: Crew Resource Management: Using Aviation Techniques to Improve Operating Room Safety. Aviation, Space, and Environmental Medicine 2012, 4: 441–444. Neily J, Mills PD, Young-Xu Y, et al.: Association Between Implementation of a Medical Team Training Program and Surgical Mortality. JAMA 2010, 15: 1721–1722. McCulloch P, Mishra A, Handa A, et al.: The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care 2009, 18: 109–115. 10.1136/qshc.2008.032045 Mayer CM, Cluff L, Lin WT, et al.: Evaluating Efforts to Optimize TeamSTEPPS Implementation in Surgical and Pediatric Intensive Care Units. Jt Comm J Qual Patient Saf 2011, 37: 365–374. Hamman WR, Beaudin-Seiler BM, Beaubien JM: Understanding interdisciplinary health care teams: using simulation design processes from the air carrier advanced qualification program to identify and train critical teamwork skills. J Patient Saf 2010, 6: 137–146. 10.1097/PTS.0b013e3181bfd7ba Patterson K, Grenny J, McMillan R, et al.: Crucial Conversations: tools for talking when stakes are high. McGraw Hill, New York; 2002. Lighthall GK, Barr J, Howard SK, et al.: Use of fully simulated intensive care unit environment for critical event management training for internal medicine residents. Crit Care Med 2003, 10: 2437–2443. Thomas EJ: Improving teamwork in healthcare: current approaches and the path forward. BMJ Qual Saf 2011, 20: 647–650. 10.1136/bmjqs-2011-000117 Reader TW, Cuthbertson BH: Teamwork and team training in the ICU: Where do similarities with aviation end? Crit Care 2011, 15: 313. 10.1186/cc10353 Koppes R: The effect of RNLAF CRM training on participant attitude and retention over time. MSc Thesis, Cranfield University; 2009.