Agarwal Hemant S, Wolfram Karen B, Slayton Jennifer M, Saville Benjamin R, Cutrer William B, Bichell David P, Harris Zena L, Barr Frederick E, Deshpande Jayant K
Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Interact Cardiovasc Thorac Surg. 2013 Oct;17(4):704-9. doi: 10.1093/icvts/ivt293. Epub 2013 Jul 5.
Few educational opportunities exist in paediatric cardiac critical care units (PCCUs). We introduced a new educational activity in the PCCU in the form of of patient-specific summaries (TPSS). Our objective was to study the role of TPSS in the provision of a positive learning experience to the multidisciplinary clinical team of PCCUs and in improving patient-related clinical outcomes in the PCCU.
Prospective educational intervention with simultaneous clinical assessment was undertaken in PCCU in an academic children's hospital. TPSS was developed utilizing the case presentation format for upcoming week's surgical cases and delivered once every week to each PCCU clinical team member. Role of TPSS to provide clinical education was assessed using five-point Likert-style scale responses in an anonymous survey 1 year after TPSS provision. Paediatric cardiac surgery patients admitted to the PCCU were evaluated for postoperative outcomes for TPSS provision period of 1 year and compared with a preintervention period of 1 year.
TPSS was delivered to 259 clinical team members including faculty, fellows, residents, nurse practitioners, nurses, respiratory therapists and others from the Divisions of Anesthesia, Cardiology, Cardio-Thoracic Surgery, Critical Care, and Pediatrics working in the PCCU. Two hundred and twenty-four (86%) members responded to the survey and assessed the role of TPSS in providing clinical education to be excellent based on mean Likert-style scores of 4.32 ± 0.71 in survey responses. Seven hundred patients were studied for the two time periods and there were no differences in patient demographics, complexity of cardiac defect and surgical details. The length of mechanical ventilation for the TPSS period (57.08 ± 141.44 h) was significantly less when compared with preintervention period (117.39 ± 433.81 h) (P < 0.001) with no differences in length of PCICU stay, hospital stay and mortality for the two time periods.
Provision of TPSS in a paediatric cardiac surgery unit is perceived to be beneficial in providing clinical education to multidisciplinary clinical teams and may be associated with improved clinical outcome.
儿科心脏重症监护病房（PCCU）的教育机会很少。我们在PCCU引入了一种新的教育活动，即针对特定患者的总结（TPSS）。我们的目的是研究TPSS在为PCCU的多学科临床团队提供积极学习体验以及改善PCCU中与患者相关的临床结果方面的作用。
在一家学术儿童医院的PCCU进行了前瞻性教育干预并同时进行临床评估。TPSS是利用下周手术病例的病例报告形式制定的，每周向每个PCCU临床团队成员提供一次。在提供TPSS一年后，通过匿名调查中五点李克特式量表的回答来评估TPSS提供临床教育的作用。对入住PCCU的儿科心脏手术患者在TPSS提供期的1年进行术后结果评估，并与干预前的1年进行比较。
TPSS提供给了259名临床团队成员，包括教员、研究员、住院医师、执业护士、护士、呼吸治疗师以及来自麻醉科、心脏病科、心胸外科、重症监护科和儿科的其他人员，他们在PCCU工作。224名（86%）成员回复了调查，根据调查回复中李克特式量表的平均得分4.32±0.71，评估TPSS在提供临床教育方面的作用为优秀。在两个时间段对700名患者进行了研究，患者的人口统计学特征、心脏缺陷的复杂性和手术细节没有差异。与干预前期（117.39±433.81小时）相比，TPSS期的机械通气时间（57.08±141.44小时）显著缩短（P<0.001），两个时间段的儿科重症监护病房（PCICU）住院时间、住院时间和死亡率没有差异。
在儿科心脏手术病房提供TPSS被认为有利于为多学科临床团队提供临床教育，并且可能与改善临床结果相关。
