使用TEAM量表評估到院前救護技術員團隊合作表現-前導研究

Evaluation of Prehospital Teamwork Performance For Emergency Medical Technician Education Training by Using TEAM SCORE – A Pilot Study.

林昱佑(Yu-You Lin)

指導教授 ： 張淑惠

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2020年)

https://doi.org/10.6342/NTU202002419

摘要

研究目的:本研究探討高級救護技術員使用經過修正後之Team Emergency Assessment Measure (TEAM)評估量表評估到院前救護技術員操作模擬急救之團隊合作之可行性。
研究背景:團隊合作與非技術性技能評估工具已被證實在許多醫療環境下能增進患者的安全及照護效率，但目前對於高級救護技術員在到院前仍缺乏合適的評估工具。
研究方法:本研究包含三個研究步驟。首先，依據系統性回顧後選擇適合緊急救護技術員到院前情境的評估工具。第二，進行專家效度分析以檢測修正後的團隊合作評估工具，簡稱Modified TEAM。最後，以集群隨機分派研究設計(Cluster randomization study design)收集資料，評估此團隊合作評估量表對於救護技術員模擬急救訓練紀錄影像之成效。
研究結果:在系統性回顧後，選擇TEAM為評估工具樣本。影像評估者使用完成專家效度分析後之Modified TEAM評估量表進行評分。共55位高級救護技術員(Emergency Medical Technician-Paramedic, EMT-P)使用Modified TEAM評核2個模擬急救影像。研究發現，在12題題目與總分的評分表現中，EMT-P年資5年以下(含)與EMT-P年資超過5年的評分者在3人EMT模擬情境影像出現了5次的統計顯著差異。而在評估5人救護技術員模擬情境影像時，各項評分結果皆未達任何統計上顯著差異。
結論:在此前導研究中，結果顯示使用Modified TEAM評估量表可以有效評估救護技術員模擬急救訓練的團隊合作，特別是在5人EMT團隊情況。

關鍵字

評估工具 ； 高級救護技術員 ； 模擬急救訓練紀錄影像 ； TEAM ； 團隊合作

並列摘要

Aim: To assess the feasibility of teamwork of emergency medical technician-Paramedic (EMT-P) using a modified TEAM tool in simulated prehospital resuscitation setting.
Background: Teamwork and non-technical skill (NTS) assessment tools have been proved to increase the patient’s safety and care efficiency in many fields of medical environment, yet there is still lack of a proper tool to assess the prehospital setting for emergency medical technicians.
Methods: This study comprised of three steps. First, we conducted a systematic review to opt for a tool that fits emergency medical technicians to be used in the prehospital setting. Secondly, we conducted an expert validity to verify the modified version of the teamwork assessment tool, called Modified TEAM. Finally, we conducted a cluster randomization study design to evaluate simulated resuscitation videos using the modified tool.
Results: We chose the TEAM tool, after a systematic review, as the fundamental template to modified. The modified TEAM scoring tool was used by the video raters after the expert validation. Fifty-five emergency medical technicians used the Modified TEAM scoring tool to evaluate 2 of simulated resuscitation videos. We found 5 out of the 12 teamwork related items and the total score were significantly different between experienced EMT and novice EMT in the 3-EMT video, and none of them were significant difference between in the 5-EMT video between experienced EMT and novice EMT.
Conclusion: In this pilot study, our result indicated that the Modified TEAM is a feasible tool to assess the teamwork among EMT’s simulated education training, especially for 5-EMT teams.

並列關鍵字

Assessment tool ； EMT-P ； Simulated resuscitation videos ； TEAM ； Teamwork

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