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Leadership during airway management in the intensive care unit: A video-reflexive ethnography study

Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify...

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Autores principales: Brewster, David J., Butt, Warwick W., Gordon, Lisi J., Sarkar, Mahbub A., Begley, Jonathan L., Rees, Charlotte E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980339/
https://www.ncbi.nlm.nih.gov/pubmed/36873881
http://dx.doi.org/10.3389/fmed.2023.1043041
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author Brewster, David J.
Butt, Warwick W.
Gordon, Lisi J.
Sarkar, Mahbub A.
Begley, Jonathan L.
Rees, Charlotte E.
author_facet Brewster, David J.
Butt, Warwick W.
Gordon, Lisi J.
Sarkar, Mahbub A.
Begley, Jonathan L.
Rees, Charlotte E.
author_sort Brewster, David J.
collection PubMed
description Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify factors that intersect with their perceptions of leadership. This study was underpinned by interpretivism, and video-reflexive ethnography was chosen as the methodology for the study. The use of both video recording (to capture the complex interactions occurring in the ICU) and team reflexivity allowed repeated analysis of those interactions by the research team. Purposive sampling was used to recruit participants from an ICU in a large tertiary and private hospital in Australia. Simulation groups were designed to replicate the typical clinical teams involved in airway management within the intensive care unit. Twenty staff participated in the four simulation activities (five staff per simulation group). Each group simulated the intubations of three patients with hypoxia and respiratory distress due to severe COVID-19. All 20 participants who completed the study simulations were invited to attend video-reflexivity sessions with their respective group. Twelve of the 20 participants (60%) from the simulations took part in the reflexive sessions. Video-reflexivity sessions (142 min) were transcribed verbatim. Transcripts were then imported into NVivo software for analysis. The five stages of framework analysis were used to conduct thematic analysis of the video-reflexivity focus group sessions, including the development of a coding framework. All transcripts were coded in NVivo. NVivo queries were conducted to explore patterns in the coding. The following key themes regarding participants’ conceptualizations of leadership within the intensive care were identified: (1) leadership is both a group/shared process and individualistic/hierarchical; (2) leadership is communication; and (3) gender is a key leadership dimension. Key facilitators identified were: (1) role allocation; (2) trust, respect and staff familiarity; and (3) the use of checklists. Key barriers identified were: (1) noise and (2) personal protective equipment. The impact of socio-materiality on leadership within the intensive care unit is also identified.
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spelling pubmed-99803392023-03-03 Leadership during airway management in the intensive care unit: A video-reflexive ethnography study Brewster, David J. Butt, Warwick W. Gordon, Lisi J. Sarkar, Mahbub A. Begley, Jonathan L. Rees, Charlotte E. Front Med (Lausanne) Medicine Effective leadership is crucial to team performance within the intensive care unit. This novel study aimed to explore how staff members from an intensive care unit conceptualize leadership and what facilitators and barriers to leadership exist within a simulated workplace. It also aimed to identify factors that intersect with their perceptions of leadership. This study was underpinned by interpretivism, and video-reflexive ethnography was chosen as the methodology for the study. The use of both video recording (to capture the complex interactions occurring in the ICU) and team reflexivity allowed repeated analysis of those interactions by the research team. Purposive sampling was used to recruit participants from an ICU in a large tertiary and private hospital in Australia. Simulation groups were designed to replicate the typical clinical teams involved in airway management within the intensive care unit. Twenty staff participated in the four simulation activities (five staff per simulation group). Each group simulated the intubations of three patients with hypoxia and respiratory distress due to severe COVID-19. All 20 participants who completed the study simulations were invited to attend video-reflexivity sessions with their respective group. Twelve of the 20 participants (60%) from the simulations took part in the reflexive sessions. Video-reflexivity sessions (142 min) were transcribed verbatim. Transcripts were then imported into NVivo software for analysis. The five stages of framework analysis were used to conduct thematic analysis of the video-reflexivity focus group sessions, including the development of a coding framework. All transcripts were coded in NVivo. NVivo queries were conducted to explore patterns in the coding. The following key themes regarding participants’ conceptualizations of leadership within the intensive care were identified: (1) leadership is both a group/shared process and individualistic/hierarchical; (2) leadership is communication; and (3) gender is a key leadership dimension. Key facilitators identified were: (1) role allocation; (2) trust, respect and staff familiarity; and (3) the use of checklists. Key barriers identified were: (1) noise and (2) personal protective equipment. The impact of socio-materiality on leadership within the intensive care unit is also identified. Frontiers Media S.A. 2023-02-16 /pmc/articles/PMC9980339/ /pubmed/36873881 http://dx.doi.org/10.3389/fmed.2023.1043041 Text en Copyright © 2023 Brewster, Butt, Gordon, Sarkar, Begley and Rees. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Brewster, David J.
Butt, Warwick W.
Gordon, Lisi J.
Sarkar, Mahbub A.
Begley, Jonathan L.
Rees, Charlotte E.
Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title_full Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title_fullStr Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title_full_unstemmed Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title_short Leadership during airway management in the intensive care unit: A video-reflexive ethnography study
title_sort leadership during airway management in the intensive care unit: a video-reflexive ethnography study
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980339/
https://www.ncbi.nlm.nih.gov/pubmed/36873881
http://dx.doi.org/10.3389/fmed.2023.1043041
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