CETT: Critical Event Team Training, the Journey to Increase Teamwork and Culture of Safety


Poster Presentation

Purpose for the Program

Critical event team training is significant to an obstetric unit. Research indicates that teamwork and perinatal safety during critical events is enhanced when multidisciplinary team training programs are implemented. The Joint Commission recommends that perinatal units implement team training and mock drills for critical obstetric events. The process for implementing a critical event team training program is presented.

Proposed Change

The goal was to improve perinatal safety and teamwork during critical events through implementing a critical event team training 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 critical event team training was eventually developed. This core team of nurses served as the key to staff buy-in. The critical event team training program divides multidisciplinary staff from the perinatal unit into four teams. These teams participate in in situ, team training simulation scenarios. These simulations are videotaped and then played back during a formal debriefing 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 involved staff participation and a need for a more formalized communication teaching format. The culture of safety survey was compared over a 2-year period, during which critical event team training was implemented, and scores dramatically increased from the baseline. Response times from incision to decision improved. The use of quantitative measuring tools and postpartum hemorrhage kits has now become the standard in postpartum hemorrhage events. Praise by the staff participants has greatly increased participation since initial implementation of the program. The staff also has 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. Multidisciplinary participation during critical event team training also has 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 critical event team training program.