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内镜非技术技能团队培训:内镜培训质量保证的下一步举措。

Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training.

作者信息

Matharoo Manmeet, Haycock Adam, Sevdalis Nick, Thomas-Gibson Siwan

机构信息

Manmeet Matharoo, Adam Haycock, Siwan Thomas-Gibson, the Wolfson Unit for Endoscopy, St. Mark's Hospital, Harrow HA1 3UJ, United Kingdom.

出版信息

World J Gastroenterol. 2014 Dec 14;20(46):17507-15. doi: 10.3748/wjg.v20.i46.17507.

Abstract

AIM

To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes.

METHODS

A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day's training utilising real clinical examples. Pre and post-course evaluation comprised participants' patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected.

RESULTS

Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training.

CONCLUSION

A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams' knowledge and safety attitudes.

摘要

目的

调查针对肠癌筛查(BCS)内镜检查团队的新型非技术技能培训是否能提高患者安全知识和态度。

方法

开发了一种针对BCS团队的新型内镜检查团队培训干预措施,并作为一项干预前后的研究进行评估。来自英国BCS培训中心的四个多学科BCS团队参与其中,团队成员包括BCS内镜医师、专科筛查从业者、内镜护士和行政人员(A)。本研究未涉及患者。专家多学科教员利用真实临床案例进行了为期一天的培训。课程前后的评估包括参与者的患者安全意识、态度和知识。还收集了整体课程评估。

结果

23名参与者参加了培训,培训干预后他们的患者安全知识从43%显著提高到55%(P≤0.001)。在感知到的患者安全知识和意识方面,41项安全态度项目中的12项(29%)有显著改善。其余安全态度项目:对患者安全的感知影响、对错误管理的态度、错误管理行动以及错误发生后的个人观点在培训后没有变化。定性和定量的整体课程评估都是积极的:21/23(91%)的参与者强烈同意/同意他们对课程满意。定性评估包括要求对BCS以外的内镜检查团队进行此类培训,并将团队培训纳入更广泛的内镜检查培训中。该研究的局限性包括没有衡量培训后临床实践中患者安全的增加情况。

结论

一个涉及患者安全、非技术技能和不良事件分析的新型综合培训包成功提高了多学科团队的知识和安全态度。

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