Simulation-based training improves patient safety climate in acute stroke care (STREAM)

Ferdinand O Bohmann; Joachim Guenther; Katharina Gruber; Tanja Manser; Helmuth Steinmetz; Waltraud Pfeilschifter; STREAM Trial investigators

doi:10.1186/s42466-021-00132-1

Simulation-based training improves patient safety climate in acute stroke care (STREAM)

Neurol Res Pract. 2021 Jul 12;3(1):37. doi: 10.1186/s42466-021-00132-1.

Authors

Ferdinand O Bohmann¹, Joachim Guenther², Katharina Gruber², Tanja Manser³, Helmuth Steinmetz², Waltraud Pfeilschifter^{2

4}; STREAM Trial investigators

Affiliations

¹ University Hospital Frankfurt, Department of Neurology, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main, Germany. ferdinand.bohmann@kgu.de.
² University Hospital Frankfurt, Department of Neurology, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main, Germany.
³ FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Olten, Switzerland.
⁴ Klinik für Neurologie und Klinische Neurophysiologie, Klinikum Lüneburg, Lüneburg, Germany.

Abstract

Background: Treatment of acute stroke performed by a multiprofessional, interdisciplinary team is highly time dependent. Interface problems are preprogrammed and pitfalls relevant to patient safety are omnipresent. The Safety Attitudes Questionnaire (SAQ) is a validated and widely used instrument to measure patient safety. The objective of this study was to evaluate the influence of Simulation-based Training of the Rapid Evaluation and Management of Acute Stroke (STREAM) on patient safety measured by SAQ in the context of acute stroke care.

Methods: During the STREAM trial at seven university hospitals in Germany from October 2017 to October 2018, an anonymous survey was conducted before and after the STREAM intervention centering around interdisciplinary simulation training. The questionnaire, based on the SAQ, included 33 items (5-point Likert scale, 1 = disagree to 5 = agree) and was addressed at the whole multiprofessional stroke team. Statistical analyses were used to examine psychometric properties as well as descriptive findings.

Results: In total 167 questionnaires were completed representing an overall response rate of 55.2%, including especially physicians (65.2%) and nurses (26.3%). Safety climate was significantly improved (pre-interventional: 3.34 ± .63 vs. post-interventional: 3.56 ± .69, p = .028). The same applies for teamwork climate among stroke teams (pre-interventional: 3.76 ± .59 vs. post-interventional: 3.84 ± .57, p = .001). The perceived benefit was most relevant among nurses.

Conclusions: The STREAM intervention centering around interdisciplinary simulation training increases perceived patient safety climate assessed by the SAQ in acute stroke therapy. These results have the potential to be a basis for future quality improvement programs.

Keywords: Acute stroke care; Patient safety; Patient safety climate; SAQ; Stroke.