基于模拟的埃博拉个人防护设备培训：沙特阿拉伯阿卜杜勒阿齐兹国王大学医院的经验。

Simulation-based training in Ebola Personal Protective Equipment for healthcare workers: Experience from King Abdulaziz University Hospital in Saudi Arabia.

机构信息

Department of Emergency Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; Clinical Skills and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Emergency Medicine, George Washington University, Washington DC, USA.

Infection Control & Environmental Health Unit, Department of Medical Microbiology & Parasitology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

J Infect Public Health. 2018 Nov-Dec;11(6):796-800. doi: 10.1016/j.jiph.2018.05.002. Epub 2018 May 17.

DOI:10.1016/j.jiph.2018.05.002

PMID:29779846

Abstract

BACKGROUND

Millions of Muslims from across the world gather annually to perform pilgrimage. This can import unusual communicable diseases such as Ebola. Communicable diseases with a high risk of mortality necessitate special training to master the required competency to avert transmission of infections. The efficacy of simulation-based training (SBT) has been shown in such circumstances.

OBJECTIVE

We sought to develop an SBT program in Ebola Personal Protective Equipment (PPE) for all healthcare workers (HCWs).

METHODS

We conducted a quasi-experimental study at the clinical skills and simulation center at the King Abdulaziz University. An interdisciplinary committee was formed to develop this program in three stages. Pre-intervention: Needs assessment "Diagnostic drill"; we conducted in-situ simulation in the emergency department (ED). High-fidelity simulator (HFS) was used as a suspected Ebola case to assess HCWs' competency of PPE. We used a checklist that was developed in accordance with the national and international guidelines. We then conducted "Train the Trainer in Ebola PPE" course to develop potential instructors.

INTERVENTION

PPE competency SBT courses. This involved focusing on trainees to be skilled in Ebola PPE and becoming trained observers using skill stations and Ebola scenario with HFS, followed by debriefing. All courses gathered participants' evaluations, pre, and post-tests. Post-intervention: In-situ simulation in the ED two months later that was similar to the diagnostic drill.

RESULTS

Pre-intervention: 7 HCWs were involved in the drill, the average score was 37% of the checklist items. For train the trainer, 19 potential PPE instructors attended the program; of them, 65% were female and 35% male, and 6 were physicians and 13 nurses. Average pre and post-tests scores were 72% and 86%, respectively.

INTERVENTION

10 PPE courses that were attended by 179 HCWs; of them, 67% were female and 33% male, and 52 were physicians, 112 nurses, and 15 others. Pre and posttests were 67% (57-75%) and 85% (81-91%), respectively, with a p-value<0.01. Post-intervention: Post Program drill's average score was 86% of the checklist items (37% in diagnostic drill).

CONCLUSIONS

Using SBT could be an effective method of developing competent HCWs in Ebola PPE.

摘要

背景

每年都有来自世界各地的数百万穆斯林前来朝圣。这可能会引入埃博拉等不常见的传染病。具有高死亡率风险的传染病需要特殊培训来掌握避免感染传播所需的能力。基于模拟的培训 (SBT) 的效果已在这种情况下得到证实。

目的

我们旨在为所有医护人员 (HCW) 开发一种埃博拉个人防护设备 (PPE) 的 SBT 计划。

方法

我们在阿卜杜勒阿齐兹国王大学临床技能和模拟中心进行了一项准实验研究。一个跨学科委员会分三个阶段制定了该计划。干预前：需求评估“诊断演练”；我们在急诊科 (ED) 进行现场模拟。高保真模拟器 (HFS) 被用作疑似埃博拉病例，以评估 HCW 对 PPE 的能力。我们使用了根据国家和国际准则制定的检查表。然后，我们进行了“埃博拉 PPE 培训师培训”课程，以培养潜在的讲师。

干预

PPE 能力 SBT 课程。这包括重点培训学员熟练掌握埃博拉 PPE，并通过技能站和 HFS 的埃博拉场景成为训练有素的观察员，然后进行汇报。所有课程都收集了参与者的评估、预测试和后测试。干预后：两个月后在 ED 进行现场模拟，类似于诊断演练。

结果

干预前：7 名 HCW 参加了演练，平均得分是检查表项目的 37%。对于培训师培训，有 19 名潜在的 PPE 讲师参加了该计划；其中，65%为女性，35%为男性，6 人为医生，13 人为护士。平均预测试和后测试得分分别为 72%和 86%。

干预

有 179 名 HCW 参加了 10 次 PPE 课程；其中，67%为女性，33%为男性，52 人为医生，112 人为护士，15 人为其他人员。预测试和后测试得分分别为 67%（57-75%）和 85%（81-91%），p 值<0.01。干预后：方案后演练的平均得分为检查表项目的 86%（诊断演练中的 37%）。