Communication in the ambulance team in prehospitalhigh-fidelity simulations : a qualitative observation study

Ambulanssjukvården blir allt viktigare i den moderna akutsjukvården då avancerad akutsjukvård kan utföras i prehospital miljö. World Health Organization menar att bristande kommunikation är orsaken till upp emot 70 procent av alla händelseavvikelser. Kommunikation i teamet har stor betydelse för samarbetet kring den skadade/sjuka patienten. Syftet var att undersöka kommunikation hos ambulansteamet vid simulerade prehospitala patientfall under utbildning i Crew Resource Management (CRM). Urvalet bestod av tolv deltagare där samtliga arbetade inom ambulanssjukvård. Datainsamlingen skedde i samband med ett utbildningsprojekt i ett ambulansdistrikt i södra Sverige och bestod av 12 stycken filmer. Dessa analyserades med hjälp av kvalitativ innehållsanalys med deduktiv ansats. I resultatet framkom tre kategorier utifrån befintliga nyckelord i CRM, adressering, readback och teamsummering. Analysen visar att de flesta fallen blir strukturerade genom kroppsspråk, ögonkontakt, att tala högt, även vid ickeadressering, icke-readback eller icke-teamsummering. Icke-verbal kommunikation såsom kroppsspråk spelar stor roll vid kommunikation i teamet. Ytterligare forskning behövs inom området för att förstå vilka effekter kommunikationen har kopplat till patientsäkerhet i det akuta prehospitala patientomhändertagandet. Ambulance services are becoming more important in modern emergency medical care as advanced emergency medical care can be carried out in the prehospital environment. According to World Health Organization poor communication causes as much as 70% of all healthcare errors. Communication in the team is of great importance for the teamwork when working with an injured/ill patient. The aim was to study communication in the ambulance team at simulated prehospital cases during an education in Crew Resource Management (CRM). The data selection consisted of twelve participants, all of whom worked in ambulance care. The data collection took place in connection with a training project in an ambulance district in southern Sweden and consisted of 12 films. These were analyzed by means of qualitative content analysis with deductive approach. The results presented three main categories based on existing keywords in CRM, addressing, readback, and team summary. The analysis show that most cases are structured through body language, eye contact, talking loudly, even at non-addressing, non-readback or non-teamsummering. Non-verbal communication like body language plays an important role in communication with the team. Further research is needed in this area to understand what effects the communication is linked to patient safety in the emergency pre-hospital patient care