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使用医学模拟人对护士进行中风吞咽筛查培训。

Using Medical Mannequins to Train Nurses in Stroke Swallowing Screening.

作者信息

Freeland Tonya R, Pathak Shweta, Garrett Racquell R, Anderson Jane A, Daniels Stephanie K

机构信息

Research Service, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA.

Department of Communication Sciences and Disorders, University of Houston, 100 Clinical Research Services, Houston, TX, 77204, USA.

出版信息

Dysphagia. 2016 Feb;31(1):104-10. doi: 10.1007/s00455-015-9666-6. Epub 2015 Oct 30.

Abstract

Screening patients admitted with stroke symptoms for risk of aspiration is often the responsibility of registered nurses (RNs). Simulation technology has become a widely used evidence-based form of training for healthcare professionals. The purpose of this study was to determine if the use of medical simulation mannequins as a training component is feasible when training and evaluating nurses administering swallowing screenings to stroke patients. A total of 32 RNs were divided into one of two training groups: didactic training only or didactic training plus simulation. Acquisition of skills was assessed immediately post-training and compared between the groups revealing significant differences between simulation group and didactic-only group for interpretation (p = 0.01) and administration (p = 0.05) accuracies. Following training to 100 % accuracy for post-training baseline competency, maintenance of skills across participants was assessed three more times over 6 weeks with the third follow-up screening completed with a standardized patient (live patient actor). While interpretation performance at each subsequent trial never equaled the baseline 100 % post-training accuracy (p = 0.001), steady improvement in performance was observed with each follow-up assessment. For screening administration, no significant differences in skills were evident between post-training baseline competency and the 6-week follow-up (p = 0.269) further confirming improvement in skills over time. Extension of screening administration and interpretation skills to the standardized patient was evident. Findings indicate that simulation training using medical mannequins can be used to train and evaluate nurses for obtainment and maintenance of swallowing screening competency.

摘要

对有中风症状的入院患者进行误吸风险筛查通常是注册护士(RN)的职责。模拟技术已成为医疗保健专业人员广泛使用的基于证据的培训形式。本研究的目的是确定在培训和评估护士对中风患者进行吞咽筛查时,使用医疗模拟人作为培训组件是否可行。共有32名注册护士被分为两个培训组之一:仅接受理论培训或接受理论培训加模拟培训。培训后立即评估技能的掌握情况,并在两组之间进行比较,结果显示模拟组和仅接受理论培训组在解读(p = 0.01)和操作(p = 0.05)准确性方面存在显著差异。在将培训后的基线能力训练到100%的准确率后,在6周内又对参与者的技能维持情况进行了三次评估,第三次随访筛查是由标准化患者(活体患者演员)完成的。虽然在随后的每次试验中,解读表现从未达到培训后基线100%的准确率(p = 0.001),但每次随访评估都观察到表现稳步提高。对于筛查操作,培训后基线能力与6周随访之间在技能方面没有明显差异(p = 0.269),这进一步证实了技能随时间的提高。将筛查操作和解读技能扩展到标准化患者身上是很明显的。研究结果表明,使用医疗模拟人进行模拟培训可用于培训和评估护士,以获得和维持吞咽筛查能力。

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