Simulation-based multidisciplinary team training decreases time to urgent operative procedures for trauma patients

Mrs Margaret Murphy1, Professor Kate Curtis2, Dr  Andrea  McCloughen2

1Westmead Hospital, Westmead , Australia, 2The University of Sydney, Camperdown, Australia

Background: Trauma teams are required to provide timely responses to life threatening traumatic injuries. Complexity of care and dependence on human performance make trauma teams vulnerable to error. Threats to patient safety are not due exclusively to inadequate knowledge or technical inabilities of the team. Errors can occur because of deficient non-technical skills. Trauma team training using simulation is widely used to teach these skills. It improves the performance of the resuscitation team in simulation. Its impact on health service delivery and patient outcomes is unknown. The aim of this study was to measure improvements in real-life trauma team performance as a result of a trauma team training program.

Method: The study was conducted at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia. A simulation based multidisciplinary trauma team training program commenced in 2009. A total of 324 multidisciplinary staff completed the program. Patient data were collected from existing trauma databases. Records of adult patients with an Injury Severity Score >12 indicating major trauma were included. Records four years before the introduction of trauma team training and four years after the training were included.

Results: There was a reduction in time to urgent operative intervention, from 2.63 hours (IQR 1.23-5.12) in the pre-intervention group to 0.55 hours (IQR 0.22-1.27) in the post-intervention group, p <0.001. In patients requiring urgent operative intervention, the death rate decreased from 25% (n=35) to 16.8% (n=25), p = 0.09. A total of 2389 major trauma patients met the study  criteria, 1116 in the pre-intervention group and 1273 in the post-intervention group.

Conclusion: Following a multidisciplianry trauma team training program there was a reduction in time to critical operative intervention for major trauma patients and trends towards decreased mortality. Integration of multidisciplinary trauma team training in trauma management holds promise to improve patient outcomes.


Biography:

Margaret is employed as a clinical nurse consultant at Westmead Hospital, Sydney.  She has an extensive clinical background in emergency nursing. Prior to working in emergency Margaret has had experience in Intensive Care, Mental Health, Education and Change Management. More recently she has worked as a principal project officer at the NSW Ministry of Health. She has a strong commitment to translational emergency care research and is currently completing her PhD. She holds executive and advisory positions with NSW Emergency Care institute and Westmead Hospital Clinical Board. She has been recognised by peers with awards that include Westmead Hospital Sydney Nurse of the Year 2014.