Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams
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Autor:innen
Brogaard, Lise
Rosvig, Lena Have
Hjorth-Hansen, Kristiane Roed
Hvidman, Lone
Hinshaw, Kim
Kierkegaard, Ole
Uldbjerg, Niels
Autor:in (Körperschaft)
Publikationsdatum
2024
Typ der Arbeit
Studiengang
Sammlung
Typ
01A - Beitrag in wissenschaftlicher Zeitschrift
Herausgeber:innen
Herausgeber:in (Körperschaft)
Betreuer:in
Übergeordnetes Werk
Frontiers in Medicine
Themenheft
DOI der Originalpublikation
Link
Reihe / Serie
Reihennummer
Jahrgang / Band
11
Ausgabe / Nummer
Seiten / Dauer
Patentnummer
Verlag / Herausgebende Institution
Frontiers Research Foundation
Verlagsort / Veranstaltungsort
Lausanne
Auflage
Version
Programmiersprache
Abtretungsempfänger:in
Praxispartner:in/Auftraggeber:in
Zusammenfassung
Introduction
Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician’s technical abilities. Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions.
Methods
We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams’ non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams’ clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0–59; average: 60–84; and high: 85–100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality.
Results
Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of “team interaction,” “anticipation,” “avoidance fixation,” and “focused communication.” Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71–0.88) and 0.84 for the clinical performance (95% CI: 0.74–0.90).
Conclusion
Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.
Schlagwörter
Fachgebiet (DDC)
150 - Psychologie
610 - Medizin und Gesundheit
610 - Medizin und Gesundheit
Veranstaltung
Startdatum der Ausstellung
Enddatum der Ausstellung
Startdatum der Konferenz
Enddatum der Konferenz
Datum der letzten Prüfung
ISBN
ISSN
2296-858X
Sprache
Englisch
Während FHNW Zugehörigkeit erstellt
Ja
Zukunftsfelder FHNW
Publikationsstatus
Veröffentlicht
Begutachtung
Peer-Review der ganzen Publikation
Open Access-Status
Gold
Lizenz
Zitation
BROGAARD, Lise, Lena Have ROSVIG, Kristiane Roed HJORTH-HANSEN, Lone HVIDMAN, Kim HINSHAW, Ole KIERKEGAARD, Niels ULDBJERG und Tanja MANSER, 2024. Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams. Frontiers in Medicine. 2024. Bd. 11. DOI 10.3389/fmed.2024.1330457. Verfügbar unter: https://doi.org/10.26041/fhnw-9312