Critical Event Team Training (CETT) is significant to an obstetrical unit. Research indicates that teamwork and Perinatal safety during critical events is enhanced when multi-disciplinary team training programs are implemented. The Joint Commission recommends that perinatal units implement team training and mock drills for critical obstetrical events. The journey to implementing a CETT program is presented.

Proposed change:

The goal was to improve perinatal safety and teamwork during critical events through implementing a CETT program.

Implementation, outcomes and evaluation:

The need to improve teamwork and perinatal safety during critical events was identified. A core team of perinatal nurses was formed along with the unit educator and director to discuss this issue. The team was introduced to simulation training. A plan to implement CETT was eventually developed. This core team of nurses served as the key to staff buy-in.

The CETT program divides multi-disciplinary staff from the perinatal unit into four teams. These teams participate in in situ, team training simulation scenarios. These simulations are video-taped and then played back during a formal de-briefing session. Education is provided on skills, equipment, and processes. A critique and action plan with recommendations is developed after the training.

Outcomes have been positive. Challenges encountered along the journey have involved staff participation and a need for a more formalized communication teaching format. The culture of safety survey was compared over a two year period, during which CETT was implemented, and scores dramatically increased from the baseline. Response times from incision to decision improved. The use of quantitative measuring tools and post partum hemmorhage (PPH) kits has now become the standard in PPH events. Praise by the staff participants has greatly increased participation since initial implementation of the program. The staff has also demonstrated taking on a more serious attitude and acceptance to simulation participation since it began. Staff surveys are favorable and reflect a sense of increased teamwork and skill competency. Multi-disciplinary participation during CETT has also increased.

Implications for nursing practice:

The program has received the attention of administrators, educators, and the safety department in the network. A grant has been received to enhance and continue the program. Approval to incorporate TeamSTEPPS, an evidence-based framework to optimize teamwork competency, has been received and will be added to the CETT program.

Keywords:

 Multi-disciplinary team, critical events, team training, perinatal safety, performance improvement