Riggall Virginia K, Smith Charlene M
Author Affiliations: Clinical Nurse Specialist, Department of Clinical Education and Nursing Research at Rochester General Health System (Dr Riggall); and Full-time Professor and Undergraduate Cochair at Wegmans School of Nursing, St John Fisher College; Research Coordinator, University of Rochester Medical Center, Highland Hospital; and Nursing Professional Development Specialist, Strong Memorial Hospital (Dr Smith), Rochester, New York.
Clin Nurse Spec. 2015 May-Jun;29(3):147-55. doi: 10.1097/NUR.0000000000000121.
PURPOSE/OBJECTIVES: The purpose of this program evaluation was to explore whether incorporating deliberate learning concepts, through the use of simulated patient scenarios to teach interprofessional collaboration skills to a healthcare team on one acute-care hospital unit, would improve the resuscitation response in the first 5 minutes on that unit.
DESIGN/SETTING: This was a pilot program evaluation utilizing a unit-based, clinical nurse specialist in the deployment of an interprofessional educational program involving simulation on an acute medical floor in a large tertiary-care hospital.
Eighty-four staff members participated in 17 simulations. The sample included first-year internal-medicine residents, registered nurses, respiratory therapists, and patient care technicians.
This was a program evaluation that used the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) (Classroom slides: TeamSTEPPS essentials; http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/slessentials.html#s3) during the presimulation/postsimulation sessions to assess the participants' perceptions of teamwork. Expected intervention behaviors were collected through observations of participants in the simulations and compared with the American Heart Association guidelines (Circulation 2010;122:S685-S670, S235-S337). Common perceptions of participants regarding the experience were obtained through open-ended evaluation questions.
Fifty-three participants completed the pre- and post-T-TPQ. Mean scores in the leadership category of T-TPQ decreased significantly (P = .003) from the pretest (median, 2.167) to the T-TPQ posttest (median, 2.566). Only 35% of the groups administered a defibrillation during the ventricular fibrillation simulation scenario, and only 1 group delivered this shock within the American Heart Association's recommended time frame of 2 minutes (Circulation 2010;122:S235-S337).
A single resuscitation simulation was not enough interventional dosage for staff to improve the resuscitation process. A longitudinal study should be conducted to determine the effectiveness of the program after staff members have repeated the program multiple times.
A unit-based quality-improvement simulation training program could help improve the first-5-minute response and resuscitation skills of staff by increasing the frequency of unit-based training overseen by the unit's clinical nurse specialist.
目的/目标:本项目评估旨在探讨,通过使用模拟患者场景向一家急症医院科室的医疗团队传授跨专业协作技能来融入刻意学习概念,是否会改善该科室前5分钟的复苏反应。
设计/背景:这是一项试点项目评估,在一家大型三级护理医院的急性内科楼层开展涉及模拟的跨专业教育项目时,由一名科室临床护理专家负责。
84名工作人员参与了17次模拟。样本包括一年级内科住院医师、注册护士、呼吸治疗师和患者护理技术员。
这是一项项目评估,在模拟前/模拟后阶段使用团队策略与工具提升绩效(TeamSTEPPS)团队合作认知问卷(T-TPQ)(课堂幻灯片:TeamSTEPPS要点;http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/slessentials.html#s3)来评估参与者对团队合作的认知。通过观察模拟中的参与者收集预期干预行为,并与美国心脏协会指南(《循环》2010年;122:S685 - S670,S235 - S337)进行比较。通过开放式评估问题获取参与者对该经历的共同认知。
53名参与者完成了T-TPQ前测和后测。T-TPQ领导力类别中的平均得分从前测(中位数,2.167)到T-TPQ后测(中位数,2.566)显著下降(P = 0.003)。在心室颤动模拟场景中,只有35%的小组进行了除颤,且只有1个小组在2分钟的美国心脏协会推荐时间范围内进行了电击(《循环》2010年;122:S235 - S337)。
单次复苏模拟对工作人员来说干预剂量不足,不足以改善复苏过程。应开展一项纵向研究,以确定工作人员多次重复该项目后该项目的有效性。
基于科室的质量改进模拟培训项目通过增加由科室临床护理专家监督的科室培训频率,有助于提高工作人员的前5分钟反应和复苏技能。