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“高级儿科生命支持”课程在西班牙儿科急诊护理中的评估与影响

Evaluation and Impact of the "Advanced Pediatric Life Support" Course in the Care of Pediatric Emergencies in Spain.

作者信息

Benito Javier, Luaces-Cubells Carlos, Mintegi Santiago, Manrique Martínez Ignacio, De la Torre Espí Mercedes, Miguez Navarro Concepción, Vazquez López Paula, Campos Calleja Carmen, Ferres Serrat Francesc, Alonso Salas María Teresa, González Del Rey Javier

机构信息

Division of Pediatric Emergency, Hospital Universitario Sant Joan de Déu, Barcelona.

Division of Pediatric Emergency, Instituto Valenciano de Pediatría, Valencia.

出版信息

Pediatr Emerg Care. 2018 Sep;34(9):628-632. doi: 10.1097/PEC.0000000000001038.

Abstract

INTRODUCTION

The Advanced Pediatric Life Support (APLS) course was introduced in the training of professionals who care for pediatric emergencies in Spain in 2005.

OBJECTIVE

To analyze the impact of the APLS course in the current clinical practice in Spanish PEDs.

METHODS

The directors of APLS courses were asked about information regarding the courses given to date, especially on the results of the satisfaction survey completed by students at the end of the course. Furthermore, in December 2014, a survey was conducted through Google Drive, specifically asking APLS students about the usefulness of the APLS course in their current clinical practice.

RESULTS

In the last 10 years since the APLS course was introduced in Spain, there have been 40 courses in 6 different venues. They involved a total of 1520 students, of whom 958 (63.0%) felt that the course was very useful for daily clinical practice. The survey was sent to 1,200 students and answered by 402 (33.5%). The respondent group most represented was pediatricians, 223 (55.5%), of whom 61 (27.3%) were pediatric emergency physicians, followed by pediatric residents, 122 (30.3%). One hundred three (25.6%) respondents had more than 10 years of professional practice and 291 (72.4%) had completed the course in the preceding four years. Three hundred forty-one of the respondents (84.9%: 95% confidence interval [CI], 81.9-87.9) said that they always use the pediatric assessment triangle (PAT) and 131 (32.6%: 95% CI, 28-37.1) reported that their organization has introduced this tool into their protocols. Two hundred twenty-three (55.5%: 95% CI, 50.6-60.3) believed that management of critically ill patients has improved, 328 (81.6%: 95% CI, 77.8-85.3) said that the PAT and the systematic approach, ABCDE, help to establish a diagnosis, and 315 (78.4%: 95% CI, 74.3-82.4) reported that the overall number of treatments has increased but that these treatments are beneficial for patients. Hospital professionals (191; 47.5%) include the PAT in their protocols more frequently than pre-hospital professionals (68.5% vs 55.4%; p <0.01) and consider PAT useful in the management of patients (60.2% vs 51.1%; p <0.05). Neither the time elapsed since the completion of the course, nor category and years of professional experience had any influence on the views expressed about the impact of the APLS course in clinical practice.

CONCLUSIONS

Most health professionals who have received the APLS course, especially those working in the hospital setting, think that the application of the systematic methods learned, the PAT and ABCDE, has a major impact on clinical practice.

摘要

引言

高级儿科生命支持(APLS)课程于2005年在西班牙引入,用于培训护理儿科急症的专业人员。

目的

分析APLS课程对西班牙儿科急诊科当前临床实践的影响。

方法

向APLS课程负责人询问有关迄今为止所授课程的信息,特别是课程结束时学生完成的满意度调查结果。此外,2014年12月,通过谷歌文档进行了一项调查,专门询问APLS学员该课程在他们当前临床实践中的实用性。

结果

自APLS课程在西班牙引入的过去10年里,在6个不同地点共举办了40期课程。共有1520名学生参加,其中958名(63.0%)认为该课程对日常临床实践非常有用。该调查发送给了1200名学生,402名(33.5%)进行了回复。回复者中占比最大的群体是儿科医生,有223名(55.5%),其中61名(27.3%)是儿科急诊医生,其次是儿科住院医师,有122名(30.3%)。103名(25.6%)回复者有超过10年的专业实践经验,291名(72.4%)在之前四年内完成了该课程。341名(84.9%:95%置信区间[CI],81.9 - 87.9)回复者表示他们总是使用儿科评估三角(PAT),131名(32.6%:95% CI,28 - 37.1)报告称他们所在机构已将此工具纳入其规程。223名(55.5%:95% CI,50.6 - 60.3)认为危重症患者的管理有所改善,328名(81.6%:95% CI,77.8 - 85.3)表示PAT和系统方法ABCDE有助于做出诊断,315名(78.4%:95% CI,74.3 - 82.4)报告称治疗的总体数量有所增加,且这些治疗对患者有益。医院专业人员(191名;47.5%)比院前专业人员更频繁地将PAT纳入其规程(68.5%对55.4%;p <0.01),并认为PAT在患者管理中有用(60.2%对51.1%;p <0.05)。课程结束后的时间间隔、专业经验的类别和年限均未对关于APLS课程在临床实践中影响的观点产生任何影响。

结论

大多数接受过APLS课程的卫生专业人员,尤其是在医院工作的人员,认为所学系统方法PAT和ABCDE的应用对临床实践有重大影响。

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