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基于多学科手术室模拟的团队培训以减少治疗错误:新西兰医院的一项可行性研究

Multidisciplinary operating room simulation-based team training to reduce treatment errors: a feasibility study in New Zealand hospitals.

作者信息

Weller Jennifer, Cumin David, Torrie Jane, Boyd Matthew, Civil Ian, Madell Dominic, MacCormick Andrew, Gurisinghe Nishanthi, Garden Alexander, Crossan Michael, Ng Wai Leap, Johnson Sharee, Corter Arden, Lee Tracey, Selander Ludvig, Cokorilo Martina, Merry Alan Forbes

机构信息

Centre for Medical and Health Sciences Education, University of Auckland and Department of Anaesthesia Auckland City Hospital.

Anaesthesiology, University of Auckland.

出版信息

N Z Med J. 2015 Aug 7;128(1418):40-51.

Abstract

AIMS

Communication failures in healthcare are frequent and linked to adverse events and treatment errors. Simulation-based team training has been proposed to address this. We aimed to explore the feasibility of a simulation-based course for all members of the operating room (OR) team, and to evaluate its effectiveness.

METHODS

Members of experienced OR teams were invited to participate in three simulated clinical events using an integrated surgical and anesthesia model. We collected information on costs, Behavioural Marker of Risk Index (BMRI) (a measure of team information sharing) and participants' educational gains.

RESULTS

We successfully recruited 20 full OR teams. Set up costs were NZ$50,000. Running costs per course were NZ$4,000, excluding staff. Most participants rated the course highly. BMRI improved significantly (P = 0.04) and thematic analysis identified educational gains for participants.

CONCLUSION

We demonstrated feasibility of multidisciplinary simulation-based training for surgeons, anesthetists, nurses and anaesthetic technicians. The course showed evidence of participant learning and we obtained useful information on cost. There is considerable potential to extend this type of team-based simulation to improve the performance of OR teams and increase safety for surgical patients.

摘要

目的

医疗保健中的沟通失误很常见,且与不良事件和治疗错误相关。基于模拟的团队培训已被提出以解决这一问题。我们旨在探讨为手术室(OR)团队所有成员开展基于模拟的课程的可行性,并评估其效果。

方法

邀请经验丰富的手术室团队成员使用综合手术和麻醉模型参与三项模拟临床事件。我们收集了有关成本、风险指数行为标志物(BMRI)(一种团队信息共享的度量)以及参与者教育收获的信息。

结果

我们成功招募了20个完整的手术室团队。设置成本为50,000新西兰元。每门课程的运营成本为4,000新西兰元,不包括工作人员。大多数参与者对该课程评价很高。BMRI显著改善(P = 0.04),主题分析确定了参与者的教育收获。

结论

我们证明了为外科医生、麻醉师、护士和麻醉技术人员开展多学科基于模拟的培训的可行性。该课程显示出参与者学习的证据,并且我们获得了有关成本的有用信息。扩展这种基于团队的模拟以提高手术室团队的表现并增加手术患者的安全性有很大潜力。

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