EFFECTIVE RESUSCITATION AND TEAM DYNAMICS PRESENTOR: DR PRAKASH MAN SHAH MODERATORS: DR BASANT RAI DR SUBASH BASNET DR RAMESH DAS
Objectives Understand the role of each resuscitation team member and team leader. Recognize the importance of teamwork during resuscitation effort. Assign essential task to team members while working as the team leader of a resuscitation effort. Reviewing your performance as a team leader or team member during a post event debriefing.
ROLE OF TEAM LEADER AND TEAM MEMBER TEAM LEADER Organizes the group Monitors individual performance Provides support Models excellent team behavior Trains and coaches Facilitates understanding Focuses on comprehensive patient care
TEAM MEMBER Clear about role assignments Prepared to fulfill role responsibilities Well practiced in resuscitation skills Knowledgeable about the algorithms Committed to success
ELEMENTS OF EFFECTIVE RESUSCITATION TEAM DYNAMICS Close-Loop communication 1. The team leader gives a message, order or assignment to a team member 2. Team leader confirms the message was heard and understood by receiving a clear response and good eye contact from team member 3. Team leader listens for confirmation from the team member that the task was performed before assigning another task.
CLEAR MESSAGES TEAM LEADER Provide clear messages and orders Encourage team members to speak clearly and distinctly Request clarification of any ambiguous message Speak in a calm and normal tone of voice
Team members Repeat the prescription medication order Question an order if it is ambiguous or not understood
CLEAR ROLES AND RESPONSIBILITIES TEAM LEADER Define all roles of team member in the clinical setting. Assign roles and responsibilities according to competence of each member. Distribute assignments evenly.
TEAM MEMBERS Perform tasks that are clearly defined and appropriately to the level of competence. Inform team leader if the role or task given is too difficult based on experience. Be prepared to assist with tasks as needed.
Potential locations for the team leader and team members during the case stimulations
KNOWING LIMITATIONS TEAM LEADERS AND MEMBERS Call for assistance early. Ask other team member to help if one team member is having difficulty. Seek advice from more experienced personnel if patient’s condition worsens.
KNOWLEDGE SHARING TEAM LEADER Encourage an environment of sharing and ask for suggestions Ask opinions of team members regarding reversible cause of arrest and factors that may be limiting effectiveness. Ask if anything has been overlooked. Consider all clinical signs that are relevant to treatment.
TEAM MEMBER Share information with other team member. Try to identify factors that may limiting the effectiveness of resuscitation effort.
CONSTRUCTIVE INTERVENTIONS TEAM LEADER Intervene if a team member is performing an incorrect step. Take corrective actions to ensure team members are performing tasks in appropriate sequence. Reassign a team member if that team member is not able to perform the task.
TEAM MEMBER Ask the team member or leader if u think that a team member is about to make a mistake. Suggest an alternative drug, drug dose or therapy if u observe an error.
REEVALUATION AND SUMMARISING TEAM LEADER Ask for suggestions from team member regarding differential diagnosis and factors contributing to ineffective resuscitation. Frequently review drugs and treatment given. Change the treatment strategy when new patient information or patient response present. Inform arriving personnel of patient’s plan and further actions.
TEAM MEMBER Draw attention to significant change in patient’s condition and increase monitoring.
MUTUAL RESPECT TEAM LEADER Speak in a friendly, controlled tone of voice. Provide positive feedback to team members. Intervene if team members begin to raise voice or speak disrespectfully. Remember that all team members are performing well
TEAM MEMBER Speak in a friendly, controlled tone of voice. Remember that the team leader and all team member are trying to perform well.