ABSTRACT
BACKGROUND: Assessing advanced life support (ALS) competence requires validated instruments. Existing instruments include aspects of technical skills (TS), non-technical skills (NTS) or both, but one instrument for detailed assessment that suits all resuscitation situations is lacking. This study aimed to develop an instrument for the evaluation of the overall ALS performance of the whole team. METHODS: This instrument development study had four phases. First, we reviewed literature and resuscitation guidelines to explore items to include in the instrument. Thereafter, we interviewed resuscitation team professionals (n = 66), using the critical incident technique, to determine possible additional aspects associated with the performance of ALS. Second, we developed an instrument based on the findings. Third, we used an expert panel (n = 20) to assess the validity of the developed instrument. Finally, we revised the instrument based on the experts' comments and tested it with six experts who evaluated 22 video recorded resuscitations. RESULTS: The final version of the developed instrument had 69 items divided into adherence to guidelines (28 items), clinical decision-making (5 items), workload management (12 items), team behaviour (8 items), information management (6 items), patient integrity and consideration of laymen (4 items) and work routines (6 items). The Cronbach's α values were good, and strong correlations between the overall performance and the instrument were observed. CONCLUSION: The instrument may be useful for detailed assessment of the team's overall performance, but the numerous items make the use demanding. The instrument is still under development, and more research is needed to determine its psychometric properties.
Subject(s)
Advanced Cardiac Life Support/standards , Clinical Competence/standards , Clinical Decision-Making , Guideline Adherence , Guidelines as Topic , Humans , Patient Care Team , Psychometrics , Reproducibility of Results , Resuscitation/instrumentation , Task Performance and Analysis , WorkloadABSTRACT
A new fast kinetic analyzer, System Olli 3000, is evaluated as an instrument for the routine clinical laboratory measurement of the activities of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase in serum. The System Olli 3000 consists of dispensers for simultaneous multiple dispensing of sample and reagents, incubators, vortex-type shakers, and a photometer with quartz fibre optics connected to a computer, allowing cycling measurements of 24 cuvets 24 times in 2 min. An unique slope search algorithm is described. The system shows a high degree of precision and a wide linearity range; activities of at least 10-fole the normal upper limit for all three of these enzymes can be measured without diluting the serum sample. As many as 380 analyses per hour (including calibration and blanks) can be carried out by one technician. For comparison, enzyme measurements were also made with an LKB 8600 Reaction Rate Analyzer and a Pye Unicam SP 8005 spectrophotometer coupled on-line to an IBM 1800 computer. Results obtained with the different instruments correlated well, especially in the region of main interest, i.e., above the normal upper limit. We conclude that the new instrument has many potentialities in kinetic analyses of nonenzymatic constituents in biological fluids.
