ABSTRACT
BACKGROUND AND IMPORTANCE: Use of video review in medicine is established in contexts such as surgery. Although not widely used in the emergency department (ED), some centres use it to evaluate non-technical skills (NTS) to support teaching and quality improvement. OBJECTIVE: There is no consensus on assessment of NTS using video review in the ED and the purpose of this review was to identify tools used in this context. DESIGN, SETTING AND PARTICIPANTS: Studies were identified using Embase, Medline, CINAHL and Google Scholar. Inclusion criterion for the review was NTS of resuscitation teams working within the ED were assessed using video review. A systematic search method was used, and results were synthesised after search criteria was checked by two independent reviewers. Authors settled on the same 9 studies eligible for inclusion. OUTCOME MEASURES AND ANALYSIS: Reliability and validity of tools identified for use in this context. Due to the heterogeneity of studies, no meta-analysis occurred. MAIN RESULTS: There are 9 studies included in the review. The review was registered with PROSPERO (Ref No: CRD42022306129). Four unique tools were identified - 6 studies used T-NOTECHS, 1 used TTCA-24, 1 used CALM and 1 used the Communication tool. T-NOTECHS is validated in the literature for use in this context. CONCLUSION: T-NOTECHS is the tool of choice for assessing ED teams in this context.
Subject(s)
Clinical Competence , Patient Care Team , Humans , Reproducibility of Results , Emergency Service, Hospital , CommunicationABSTRACT
INTRODUCTION: Thrombolysis was rarely given in emergency departments in Scotland when last studied in 1996. This study aimed to review the current practice of Scottish emergency departments with respect to thrombolysis for acute myocardial infarction. METHODS: Postal questionnaires were sent to all emergency departments in Scotland staffed by at least one consultant in emergency medicine, assessing the processes used for thrombolysis of acute myocardial infarction in the emergency department. A reminder letter was sent to non-responders after 1 month. All results were anonymized. RESULTS: The response rate was 77% (23 questionnaires from 30 hospitals). Twenty (87%) emergency departments performed thrombolysis according to protocol. In 13 emergency departments, thrombolysis was initiated by the emergency department staff, in six by on-call physicians and one emergency department had nurse-led thrombolysis. Twelve emergency departments occasionally received patients who had been given prehospital thrombolysis. Six hospitals had on-site primary angioplasty but only two hospitals had a 24-h service. Thirteen respondents thought the emergency department was the most appropriate place for thrombolysis, four felt that prehospital thrombolysis was best and one thought that coronary care was optimal. Four respondents felt that prehospital or the emergency department were the best options. CONCLUSION: Most emergency departments in Scotland are now administering thrombolysis for patients with acute myocardial infarction. Thrombolysis, delivered either in the prehospital arena or in the emergency department, is likely to be the primary option for patients with acute myocardial infarction in Scotland in the foreseeable future.
