Enhancing Resuscitation Performance: The Impact of Team Resource Management and In-Situ Simulation on Teamwork and Procedure Adherence.
Journal
Acta Cardiologica Sinica
Journal Volume
42
Journal Issue
2
Pages
246 - 257
ISSN
1011-6842
Date Issued
2026-03
Author(s)
Hsieh, Ming-Yuan
Chou, An-Kuo
Liu, Cheng-Heng
Lee, Chien-Feng
Abstract
Ward resuscitation requires both technical and teamwork skills, however conventional drills rarely address teamwork. We evaluated whether a brief Team Resource Management (TRM) curriculum combined with in-situ simulations could improve the quality of resuscitation and safety culture.
This retrospective study analyzed data from a hospital-wide quality-improvement project at a 250-bed regional hospital. Ward teams (physicians, nursing specialists, and nurses) completed three training cycles at baseline, 6 months, and 12 months. Each cycle included 30-min online modules plus two in-situ simulations with TRM-focused debriefs. The primary outcome was resuscitation protocol adherence (RPA) using a 28-item checklist based on the 2020 ILCOR recommendations. The secondary outcomes were Safety Attitudes Questionnaire (SAQ) and Teamwork Perception Questionnaire (TPQ) scores.
Fifty-three of 94 eligible staff (56%) provided complete responses. The mean RPA rate increased from 76.5 ± 16.5% at baseline to 92.6 ± 9.7% after cycle three (p = 0.030), primarily driven by improvements in the "Transmission of Rescue Information" domain (62.5% vs. 90.6%, p = 0.028). No significant changes occurred in composite SAQ/TPQ scores.
Three low-fidelity TRM simulations significantly increased the rate of RPA, particularly team communication, without immediate changes in the overall safety culture. Short, recurring TRM drills rapidly enhanced process reliability; sustained coaching may be needed for broader cultural transformation.
Subjects
Cardiopulmonary resuscitation
Patient safety
Quality improvement
Safety culture
Simulation training
Team Resource Management
Publisher
Republic of China Society of Cardiology
Type
journal article