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危机资源管理和团队汇报在护理学生复苏教育中的效果:一项随机对照试验。

The effectiveness of crisis resource management and team debriefing in resuscitation education of nursing students: A randomised controlled trial.

机构信息

Department Health Care, Nursing Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Brussels, Belgium.

Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium.

出版信息

J Clin Nurs. 2018 Jan;27(1-2):77-85. doi: 10.1111/jocn.13846. Epub 2017 Jun 27.

Abstract

AIMS AND OBJECTIVES

The aim of this study was to investigate (i) whether integrating a course on crisis resource management principles and team debriefings in simulation training, increases self-efficacy, team efficacy and technical skills of nursing students in resuscitation settings and (ii) which phases contribute the most to these outcomes.

BACKGROUND

Crisis resource management principles have been introduced in health care to optimise teamwork. Simulation training offers patient safe training opportunities. There is evidence that simulation training increases self-efficacy and team efficacy but the contribution of the different phases like crisis resource management principles, simulation training and debriefing on self-efficacy, team efficacy and technical skills is not clear.

DESIGN

Randomised controlled trial in a convenience sample (n = 116) in Belgium. Data were collected between February 2015-April 2015.

METHODS

Participants in the intervention group (n = 60) completed a course on crisis resource management principles, followed by a simulation training session, a team debriefing and a second simulation training session. Participants in the control group (n = 56) only completed two simulation training sessions. The outcomes self-efficacy, team efficacy and technical skills were assessed after each simulation training. An ancillary analysis of the learning effect was conducted.

RESULTS

The intervention group increased on self-efficacy (2.13%, p = .02) and team efficacy (9.92%, p < .001); the control group only increased significantly on team efficacy (4.5%, p = .001). The intervention group scored significantly higher on team efficacy (8.49%, p < .001) compared to the control group.

CONCLUSION

Combining crisis resource management principles and team debriefings in simulation training increases self-efficacy and team efficacy. The debriefing phase contributes the most to these effects.

RELEVANCE TO CLINICAL PRACTICE

By partnering with healthcare settings, it becomes possible to offer interdisciplinary simulation training that can increase patient safety.

摘要

目的和目标

本研究旨在探讨:(i)在模拟培训中整合危机资源管理原则和团队讨论课程是否会提高护理学生在复苏环境中的自我效能、团队效能和技术技能;(ii)哪些阶段对这些结果的贡献最大。

背景

危机资源管理原则已在医疗保健中引入,以优化团队合作。模拟培训提供了安全的培训机会。有证据表明,模拟培训可以提高自我效能和团队效能,但危机资源管理原则、模拟培训和讨论对自我效能、团队效能和技术技能的不同阶段的贡献尚不清楚。

设计

在比利时的便利样本中进行了一项随机对照试验(n=116)。数据收集于 2015 年 2 月至 2015 年 4 月之间。

方法

干预组(n=60)的参与者完成了危机资源管理原则课程,随后进行了模拟培训、团队讨论和第二次模拟培训。对照组(n=56)的参与者仅完成了两次模拟培训。在每次模拟培训后评估自我效能、团队效能和技术技能的结果。进行了学习效果的辅助分析。

结果

干预组的自我效能(2.13%,p=0.02)和团队效能(9.92%,p<0.001)均有所提高;对照组仅在团队效能方面显著提高(4.5%,p=0.001)。干预组的团队效能得分(8.49%,p<0.001)明显高于对照组。

结论

在模拟培训中整合危机资源管理原则和团队讨论可以提高自我效能和团队效能。讨论阶段对这些效果的贡献最大。

临床相关性

通过与医疗保健机构合作,可以提供跨学科模拟培训,从而提高患者安全性。

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