Engelke Monika, Grund Karl-Ernst, Schilling Dieter, Beilenhoff Ulrike, Kern-Waechter Elisabeth, Engelke Olaf, Stebner Ferdinand, Kugler Christiane
Universität Witten/Herdecke, Witten, Germany.
Bildungszentrum Ruhr, Herne, Germany.
Z Gastroenterol. 2018 Mar;56(3):239-248. doi: 10.1055/s-0043-120350. Epub 2017 Nov 7.
Percutaneous endoscopic gastrostomy (PEG) insertion represents a standardized procedure for enteral nutrition in patients with long-term eating difficulties for various reasons. In a clinical setting, delegation of stomach puncture and placement of a PEG tube, within the context of percutaneous endoscopic gastrostomy amongst nurses, occurs. In Germany, there are no studies yet showing the differences between physicians and nurses regarding the safety of percutaneous stomach puncture.In a non-randomized quasi-experimental interventional study on a simulation model, the safety of stomach puncture within the context of percutaneous endoscopic gastrostomy between physicians and nurses with special training was compared. Technical skills were recorded with video cameras and provided the basis for the following analysis. The study contained: (1) a theoretical preparation phase, (2) training on simulation model and a repeated practice of the skills, and (3) stomach puncture on the simulation model. The actions were recorded with a multichannel video technique. As part of the concept, nurses and physicians were trained together in theory and practice. The analysis was conducted with the newly designed Assessment Instrument Percutaneous Endoscopic Gastrostomy (AS-PEG). Seven physicians and 17 nurses took part in the pilot study. On average, the physicians reached a score of 36.4 ± 2.2 (33 - 39) and nurses 37.4 ± 2 (32 - 40), while the maximum score was 42. The evaluation of technical skills on the recorded videos by means of Assessment Instrument Percutaneous Endoscopic Gastrostomy (AS-PEG) showed no tendency to significant differences between physicians and nurses after theoretical and practical training. The study contributes a first objective evaluation of technical skills on stomach puncture within the context of percutaneous endoscopic gastrostomy with the newly designed AS-PEG.
经皮内镜下胃造口术（PEG）置入是针对因各种原因长期存在进食困难患者的一种标准化肠内营养方法。在临床环境中，护士会在经皮内镜下胃造口术的操作过程中进行胃穿刺和PEG管置入。在德国，尚无研究表明医生和护士在经皮胃穿刺安全性方面存在差异。在一项基于模拟模型的非随机准实验性干预研究中，比较了接受特殊培训的医生和护士在经皮内镜下胃造口术过程中胃穿刺的安全性。用摄像机记录技术操作，为后续分析提供依据。该研究包括：（1）理论准备阶段，（2）模拟模型培训及技能反复练习，（3）模拟模型上的胃穿刺。操作过程用多通道视频技术记录。作为概念的一部分，护士和医生在理论和实践方面一起接受培训。分析采用新设计的经皮内镜下胃造口术评估工具（AS - PEG）进行。7名医生和17名护士参与了试点研究。医生平均得分为36.4±2.2（33 - 39），护士平均得分为37.4±2（32 - 40），而最高分是42分。通过经皮内镜下胃造口术评估工具（AS - PEG）对记录视频中的技术技能进行评估，结果显示在理论和实践培训后，医生和护士之间没有显著差异的趋势。该研究通过新设计的AS - PEG对经皮内镜下胃造口术过程中胃穿刺的技术技能进行了首次客观评估。
