PDF(Pubmed)
Abstract：
Globally, at least one adverse event occurs in 10% of patients using emergency, inpatient, outpatient, surgical and primary care services. Particularly in emergency health care, this problem is exacerbated by additional variables such as patient criticality, high-risk diagnostic and therapeutic interventions and varying levels of healthcare provider training. In relation to the last point, briefing and debriefing activities during an emergency reinforce staff training and support them in managing work resources, planning interventions and improving future performance. The aim of the scoping review is to explore the state of the art in human factors applied to emergency situations and to develop a new tool to support healthcare professionals in conducting evidence-based briefings and debriefings. This review was developed using a search strategy based on the Arksey and O\'Malley\'s six-step framework for scoping reviews. The literature analysed and the data identified, which are heterogeneous due to different study methodologies, objectives and types of interventions, suggest that human factors applied to emergency situations are still under-researched. At the end of the data extraction, analysis process, authors\' reviews, discussion rounds and comparison with the multidisciplinary team of healthcare providers, 42 behaviours, 33 elements and 8 domains were considered relevant and included in the Emergency Team Comptencies (ETC) briefing and debriefing tool, ranked in order of priority as follows: communication, decision-making, clinical skills, situational awareness, leadership, task management, collaboration and stress and fatigue management. Further research is needed to investigate human factors applied to emergency situations and to generate new evidence to improve clinical practice and reduce the risk of error. In the near future, further studies will be conducted by the authors to test the validity of the Emergency Team Competencies tool in objectively measuring the performance of professionals and multidisciplinary teams.
摘要：
全球范围内,至少有一个不良事件发生在10％的患者使用急诊，住院,门诊病人,外科和初级保健服务。特别是在紧急医疗中，这个问题是加剧了额外的变量，如病人的重要性，高风险的诊断和治疗干预措施以及不同水平的医疗保健提供者培训。关于最后一点，紧急情况下的简报和汇报活动加强员工培训，支持他们管理工作资源，规划干预措施并提高未来绩效。范围审查的目的是探索适用于紧急情况的人为因素的最新技术，并开发一种新工具，以支持医疗保健专业人员进行基于证据的简报和汇报。本评论是使用基于Arksey和O\'Malley的六步范围审查框架的搜索策略开发的。文献分析和数据确定，由于不同的研究方法，它们是异质的，干预措施的目标和类型，表明适用于紧急情况的人为因素仍未得到充分研究。在数据提取结束时，分析过程，作者\'评论，与多学科医疗保健提供者团队进行讨论和比较，42种行为，33个元素和8个领域被认为是相关的，并包括在应急小组能力（ETC）简报和汇报工具中。按优先顺序排列如下:通信，决策,临床技能，态势感知,领导力,任务管理,协作以及压力和疲劳管理。需要进一步的研究来调查适用于紧急情况的人为因素，并产生新的证据来改善临床实践并降低错误的风险。在不久的将来,作者将进行进一步的研究，以测试应急小组能力工具在客观衡量专业人员和多学科团队绩效方面的有效性。
