Background: Prior studies suggest interprofessional teamwork training improves trauma resuscitation team performance and outcomes. This study explores whether additional improvements are observed with advanced trauma nurse training in comparison with prior interprofessional teamwork studies conducted in the same setting. Methods: This is a prospective, guasiexperimental preintervention and postintervention study incorporating TeamSTEPPS (R) with interprofessional simulations. Results: Trauma nurses' self-confidence in skills increased significantly in all areas after training (p < .05). Trauma resuscitation team performance improved significantly after training but degraded between 6 and 12 months after training. The greatest decline in performance over time was seen in the readership domain (p < .05). Conclusions: Study findings support prior studies, suggesting teamwork training improves team attitudes and performance. Interprofessional trauma resuscitation team training provided every 6 months may support sustained improvement gains over time. (C) 2019 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.

Problem: Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Methods: Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. Results: Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Implications for practice: Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential.

OBJECTIVES: We investigated these questions: Does formal team training improve team behaviors in the trauma resuscitation bay? If yes, then does improved teamwork lead to more efficiency in the trauma bay and/or improved clinical outcomes?DESIGN: This intervention study used a pretraining/posttraining design. The intervention was TeamSTEPPS augmented by simulation. The evaluation instrument, which was the Trauma Team Performance Observation Tool (TPOT), was used by trained evaluators to assess teams' performance during trauma resuscitations. From November 2008 to February 2009, a convenience sample (n = 33) of trauma resuscitations was evaluated. From February to April 2009, team training was conducted. From May to July 2009, another sample (n = 40) of resuscitations were evaluated. Clinical data were gathered from our trauma registry. The clinical parameters included time from arrival to computed tomography (CT) scanner, arrival to intubation, arrival to operating room, arrival to Focused Assessment Sonography in Trauma (FAST) examination, time in emergency department (ED), hospital length of stay (LOS), intensive care unit LOS, complications, and mortality. Comparing pretraining and posttraining resuscitations, we calculated means, standard deviations, and p values for teamwork ratings and clinical parameters, and we determined significance using the independent samples t-test.SETTING: Level I Trauma Center.PARTICIPANTS: The trauma team included surgery residents, faculty, and nurses.RESULTS: Our trauma team showed significant improvement in all teamwork domain ratings and overall ratings from pretraining to posttraining leadership (2.87-3.46, p = 0.003), situation monitoring (3.30-3.91, p = 0.009), mutual support (3.40-3.96, p = 0.004), communication (2.90-3.46, p = 0.001), and overall (3.12-3.70, p < 0.001). The times from arrival to the CT scanner (26.4-22.1 minutes, p = 0.005), endotracheal intubation (10.1-6.6 minutes, p = 0.49) and the operating room (130.1-94.5 minutes, p = 0.021) were decreased significantly after the training.CONCLUSIONS: Structured trauma resuscitation team training augmented by simulation improves team performance, resulting in improved efficiency of patient care in the trauma bay. We propose that formal teamwork training augmented by simulation be included in surgery residency training as well as Advanced Trauma Life Support (AILS). (J Surg 67:439-443. (C) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)