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| Name | Class |
|---|---|
| Norwegian University of Science and Technology | OTHER |
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Medication administration events have the potential to cause patient harm. Frequency of medication administration events in the ambulance services is less known. Effective teamwork has been described as paramount for providing safe and effective patient care in the high-risk ambulance environment. "Team Strategies and Tools to Enhance Performance and Patient Safety®" is an evidence-based team training program released from the Agency for Healthcare Research and Quality.
The aims of the study are: (1) to advance the knowledge of medication administration process in the ambulance services, and (2) to study the impact of a team training program on medication administration events, teamwork, and patient safety culture.
To address the overall aims, the following research objectives will guide the study:
Pre-study: To analyse and validate the psychometric properties of the Norwegian version of the Teamwork Perception Questionnaire for use in an ambulance service.
Studies:
Post-study: To study the association between medication administration events and team training and patient safety culture in an ambulance service.
A quasi-experimental, pre- and post-design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cluster 1. | Experimental | The clusters will be formed from two ambulance stations (Approximately 50 participants). |
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| Cluster 2. | Experimental | The clusters will be formed from five ambulance stations (Approximately 70 participants). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®" | Other | "Team Strategies and Tools to Enhance Performance and Patient Safety®" is a team training program consisting of an evidence-based set of tools designed to develop teamwork skills with the goal of improving quality in healthcare services and providing safer patient care. In this study, selected tools from the "Team Strategies and Tools to Enhance Performance and Patient Safety®" curriculum have been chosen for implementation over a 4-month period together with a general emphasis on the key principles: communication, leadership, situation monitoring and mutual support. A full day introduction will be held to mark the start of the intervention and each successive month will have a focus on a single key principle with associated tools. A quasi-experimental, pre- post design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total. |
| Measure | Description | Time Frame |
|---|---|---|
| Testing the psychometric properties of the Teamwork Perception Questionnaire | The questionnaire will be digitally distributed to approximately 500 ambulance personnel in a hospital trust. Each items are scored on a five-point scale. The survey will be carried out for 14 days in February, and 14 days in August 2022. | 4 weeks |
| The perception of patient safety culture and teamwork. | To measure the ambulance personnel's perception of patient safety culture and teamwork, the Prehospital Survey on Patient Safety Culture (five point-scale) and the Teamwork Perception Questionnaire (five point-scale), will be carried out at three times in each cluster (one time before and two times after the intervention) In cluster 1, the survey will be carried out for 14 days in January/February 2022, 14 days in June 2022 and 14 days in January 2023. In cluster 2, the survey will be carried out for 14 days in August 2022, 14 days in January 2023 and 14 days in August 2023. | 3 month |
| The frequency of medication administration in ambulance service | The frequency of medication administration will be assed by a retrospective review of approximately 500 electronic patient journals before the intervention. An interim analysis will be conducted after the this review to determine the final number of necessary review of electronic patient journals after the intervention. The journals will be collected for a 6-month period prior to the intervention and a 12-month period after the end of the intervention in both clusters. | 18 month |
| Description of the medication administration process. | Qualitative data from partly participants observations, approximately 10 individual interviews of ambulance professionals and supplemented by local guidelines. | 3 month |
| The experiences of teamwork and the team training program before and after the intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Association between medication administration, team training and patient safety culture | The study include data from the primary outcome measures 2 and 3. | 21 month |
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Inclusion criteria pre-study
Exclusion criteria pre-study
Inclusion criteria study 1 and 3
Exclusion criteria study 1 and 3
Inclusion criteria study 2
Exclusion criteria study 2
Inclusion criteria study 4 and 5
Exclusion criteria study 4 and 5
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| Name | Affiliation | Role |
|---|---|---|
| Ingeborg Hartz, PhD | Sykehuset Innlandet HF | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Innlandet Hospital Trust | Brumunddal | 2381 | Norway |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41580728 | Derived | Myhr K, Ballangrud R, Porthun J, Sollid SJM, Vifladt A. Medication administration errors in a Norwegian ambulance service: a quasi-experimental study on the impact of a team training program. Scand J Trauma Resusc Emerg Med. 2026 Jan 24;34(1):41. doi: 10.1186/s13049-026-01560-1. | |
| 38956498 | Derived | Myhr K, Ballangrud R, Aase K, Vifladt A. Ambulance professionals' experiences of teamwork in the context of a team training programme - a qualitative study. BMC Emerg Med. 2024 Jul 2;24(1):108. doi: 10.1186/s12873-024-01018-6. |
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| ID | Term |
|---|---|
| D061214 | Patient Safety |
| ID | Term |
|---|---|
| D012449 | Safety |
| D000056 | Accident Prevention |
| D000059 | Accidents |
| D011634 | Public Health |
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A quasi-experimental, pre- post design, imply the framework for how the "Team Strategies and Tools to Enhance Performance and Patient Safety®" intervention will be introduced in the two clusters. To ease the logistics need for training and the implementation, two clusters will be formed from seven ambulance stations within the same organization. The order in which the two clusters will undergo the intervention will be randomized. The intervention will be introduced for one cluster in February 2022, and for the other cluster in September 2022.
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Qualitative data from from four focus group interviews before and after the intervention in each cluster. |
| 4 days |
| 36669839 | Derived | Vifladt A, Ballangrud R, Myhr K, Grusd E, Porthun J, Maehlum PA, Aase K, Sollid SJM, Odberg KR. Team training program's impact on medication administration, teamwork and patient safety culture in an ambulance service (TEAM-AMB): a longitudinal multimethod study protocol. BMJ Open. 2023 Jan 20;13(1):e067006. doi: 10.1136/bmjopen-2022-067006. |
| D004778 |
| Environment and Public Health |