Paltved Charlotte, Bjerregaard Anders Thais, Krogh Kristian, Pedersen Jonas Juul, Musaeus Peter
1Centre for Health Sciences Education, Aarhus University, Aarhus, Denmark.
Corporate HR MidtSim, the Central Region of Denmark, Aarhus, Denmark.
Adv Simul (Lond). 2017 Feb 8;2:4. doi: 10.1186/s41077-017-0037-2. eCollection 2017.
This intervention study aimed to enhance patient safety attitudes through the design of an in situ simulation program based on a needs analysis involving thematic analysis of patient safety data and short-term ethnography. The study took place at an Emergency Department (ED) in the Central Region of Denmark. Research suggests that poor handover communication can increase the likelihood of critical incidents and adverse events in the ED. Furthermore, simulation is an effective strategy for training handover communication skills. Research is lacking, however, on how to use patient safety data and a needs analysis to the design of in situ simulation communication training.
This is a prospective pre-post study investigating the interventional effects of in situ simulation. It used a three-pronged strategy: (1) thematic analysis of patient safety data consisting of reported critical incidents and adverse events, (2) a needs analysis based on short-term ethnography in the ED, and (3) pre-post evaluation using the validated Safety Attitudes Questionnaire (SAQ) and the Trainee Reactions Score.
Sixteen different healthcare teams participated composed by 9 physicians and 30 nurses. In the SAQ, participating staff scored their safety attitudes in six categories ( = 39). Two measures where significantly higher for the post-SAQ than those for the pre-SAQ: teamwork climate ( < 0.001) and safety climate ( < 0.05). The Trainee Reactions Score showed that the training was positively evaluated.
This study designed a feasible strategy for implementing in situ simulation based on a needs analysis of critical incidents and adverse events and short-term ethnography.
本干预性研究旨在通过基于需求分析设计一个现场模拟项目来提高患者安全态度，该需求分析涉及对患者安全数据的主题分析和短期人种志研究。该研究在丹麦中部地区的一家急诊科进行。研究表明，交接沟通不畅会增加急诊科发生严重事件和不良事件的可能性。此外，模拟是培训交接沟通技能的有效策略。然而，关于如何利用患者安全数据和需求分析来设计现场模拟沟通培训的研究尚属空白。
这是一项前瞻性前后对照研究，旨在调查现场模拟的干预效果。它采用了三管齐下的策略：（1）对包括报告的严重事件和不良事件在内的患者安全数据进行主题分析；（2）基于急诊科的短期人种志进行需求分析；（3）使用经过验证的安全态度问卷（SAQ）和学员反应评分进行前后评估。
16个不同的医疗团队参与其中，由9名医生和30名护士组成。在SAQ中，参与人员在六个类别中对他们的安全态度进行了评分（=39）。SAQ后测的两项指标显著高于前测：团队合作氛围（<0.001）和安全氛围（<0.05）。学员反应评分表明该培训得到了积极评价。
本研究基于对严重事件和不良事件的需求分析以及短期人种志研究，设计了一种可行的实施现场模拟的策略。
