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Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool

BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to...

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Autores principales: Costa, Deena Kelly, Dammeyer, Jennifer, White, Matthew, Galinato, Jose, Hyzy, Robert, Manojlovich, Milisa, Sales, Anne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990869/
https://www.ncbi.nlm.nih.gov/pubmed/27538395
http://dx.doi.org/10.1186/s13104-016-2213-1
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author Costa, Deena Kelly
Dammeyer, Jennifer
White, Matthew
Galinato, Jose
Hyzy, Robert
Manojlovich, Milisa
Sales, Anne
author_facet Costa, Deena Kelly
Dammeyer, Jennifer
White, Matthew
Galinato, Jose
Hyzy, Robert
Manojlovich, Milisa
Sales, Anne
author_sort Costa, Deena Kelly
collection PubMed
description BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU. RESULTS: We pilot tested and evaluated reliability of an observational rating tool to assess team interactions about ABCDE. Two independent raters used this tool in one medical ICU over 4 weeks during morning rounds. We examined which ABCDE components were addressed, which team members initiated interactions, and which participated in interactions about ABCDE. We evaluated inter-rater reliability using Cohen’s kappa statistic and data from interprofessional team interactions for 23 patients. We demonstrated moderate to substantial reliability for whether breathing, coordination, delirium or early mobility were addressed (k = 0.48–0.78) and slight to fair reliability for which team members initiated interactions about ABCDE (0.18–0.40). Reliability was low for whether Awakening was addressed (k = −0.07) and for which team members initiated interactions about awakening (k = 0.05). CONCLUSIONS: Our study provides pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE. Future work should further test and modify this tool to gain an understanding of how to use team interactions to improve ABCDE delivery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-016-2213-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-49908692016-08-20 Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool Costa, Deena Kelly Dammeyer, Jennifer White, Matthew Galinato, Jose Hyzy, Robert Manojlovich, Milisa Sales, Anne BMC Res Notes Short Report BACKGROUND: The awakening and breathing coordination, delirium, and early mobility (ABCDE) bundle is a multicomponent complex intervention that improves outcomes for critically ill adults yet is inconsistently implemented. Effective interprofessional team function (how the team interacts) is key to ABCDE delivery but little is known about how to measure team interactions. The purpose of our study was to examine the reliability of an observational rating tool to assess team interactions about ABCDE in one ICU. RESULTS: We pilot tested and evaluated reliability of an observational rating tool to assess team interactions about ABCDE. Two independent raters used this tool in one medical ICU over 4 weeks during morning rounds. We examined which ABCDE components were addressed, which team members initiated interactions, and which participated in interactions about ABCDE. We evaluated inter-rater reliability using Cohen’s kappa statistic and data from interprofessional team interactions for 23 patients. We demonstrated moderate to substantial reliability for whether breathing, coordination, delirium or early mobility were addressed (k = 0.48–0.78) and slight to fair reliability for which team members initiated interactions about ABCDE (0.18–0.40). Reliability was low for whether Awakening was addressed (k = −0.07) and for which team members initiated interactions about awakening (k = 0.05). CONCLUSIONS: Our study provides pilot evidence of reliability of an observational rating tool to assess interprofessional team interactions about ABCDE. Future work should further test and modify this tool to gain an understanding of how to use team interactions to improve ABCDE delivery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13104-016-2213-1) contains supplementary material, which is available to authorized users. BioMed Central 2016-08-18 /pmc/articles/PMC4990869/ /pubmed/27538395 http://dx.doi.org/10.1186/s13104-016-2213-1 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Short Report
Costa, Deena Kelly
Dammeyer, Jennifer
White, Matthew
Galinato, Jose
Hyzy, Robert
Manojlovich, Milisa
Sales, Anne
Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title_full Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title_fullStr Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title_full_unstemmed Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title_short Interprofessional team interactions about complex care in the ICU: pilot development of an observational rating tool
title_sort interprofessional team interactions about complex care in the icu: pilot development of an observational rating tool
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990869/
https://www.ncbi.nlm.nih.gov/pubmed/27538395
http://dx.doi.org/10.1186/s13104-016-2213-1
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