An application of situational awareness to child resuscitation

An estimated 23,000 preventable deaths occur annually in Canadian hospitals. One area of practice that is particularly time-sensitive and prone to errors is child resuscitation. The range of medical conditions underlying the need for child resuscitation, and the broad range in age and size of children, make this event one of the most stressful for healthcare providers. As a first responder, nurse performance is crucial to resuscitation outcomes. Situational awareness (SA) describes an individual’s awareness of what is happening, why it is happening and what will happen next. SA has been proposed as the primary basis for decision-making and performance in complex, dynamic systems and has been used extensively in high risk industries such as aviation and the military to understand how people assess threats and ensure safety within the work environment. Kimberley Shearer was previously funded by MSFHR for her early PhD work in situational awareness. She is continuing her research into the SA requirements for nurses during child resuscitation, determining what nurses need to pay attention to and anticipate in order to prevent error. She is developing a tool for objectively measuring nurse SA based on information gathered from a series of in-depth interviews with resuscitation team nurses. The tool will be validated by comparing the performance and stress levels demonstrated by novice and expert nurses during a simulated child resuscitation. Shearer’s research has implications for simulation teaching to reduce clinician error in pediatric settings. The development of an objective measure of SA can assist in the evaluation of clinician performance, facilitate understanding of differences between novices and experts, and permit testing of the effects of changes in technology on clinician performance.