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培养床边医护人员的自主决策能力,以促进其积极参与快速反应事件。

Fostering self-determination of bedside providers to promote active participation in rapid response events.

机构信息

a Baylor College of Medicine , Texas Children's Hospital , Houston , Texas , USA.

b Section of Critical Care Medicine, Department of Pediatrics , Baylor College of Medicine , Houston , Texas , USA.

出版信息

Med Educ Online. 2019 Dec;24(1):1551028. doi: 10.1080/10872981.2018.1551028.

Abstract

BACKGROUND

Widespread implementation of rapid response (RR) systems positively impacts outcomes of clinically unstable hospitalized patients. Collaboration between bedside providers and specialized responding teams is crucial for effective functioning of RR system. Bedside, providers often harbor negative feelings about having to 'call for help' that could impact their active participation in RR.

OBJECTIVE

The objective of the study is to enhance active participation of bedside providers in RR by fostering self-determination through targeted education.

DESIGN

Needs assessment affirmed that bedside providers in our tertiary academic pediatric hospital felt loss of control over patient care, lack of competence, and disconnect from the RR team. We used the principles of autonomy, competence, and relatedness posited by the self-determination theory to guide the development, implementation, and evaluation of our educational program for bedside providers.

RESULTS

Forty-two bedside providers participated in our program. Participants reported significant improvement in RR-related clinical knowledge. More importantly, there was significant enhancement in individual perceptions of autonomy (pre-mean: 2.12, post-mean: 4.4) competence (pre-mean: 2.15, post-mean: 4.4), and relatedness (pre-mean: 2.65, post-mean: 4.5) with RR (p < 0.01). The evaluation results for overall educational effectiveness showed a mean score of 4.69 ± 0.79. All scores were based on a 5-point Likert scale of 1: poor to 5: excellent. Educators noted good participant engagement. The program's structure, evaluations, and data management were modified based on the feedback.

CONCLUSIONS

We successfully developed and implemented targeted educational program for bedside providers based on self-determination theory. The evaluations showed improvement in bedside providers' clinical RR knowledge and perceptions of autonomy, competence, and relatedness following the training.

摘要

背景

广泛实施快速反应 (RR) 系统对临床不稳定住院患者的结局有积极影响。床边医护人员与专业响应团队之间的协作对于 RR 系统的有效运作至关重要。床边医护人员常常对必须“寻求帮助”持有负面感受,这可能会影响他们积极参与 RR。

目的

本研究旨在通过有针对性的教育培养自我决定能力,从而增强床边医护人员在 RR 中的积极参与。

设计

需求评估证实,我们的三级学术儿科医院的床边医护人员感到对患者护理失去控制、缺乏能力,并且与 RR 团队脱节。我们使用自我决定理论提出的自主性、能力和关联性原则来指导床边医护人员教育计划的开发、实施和评估。

结果

42 名床边医护人员参加了我们的计划。参与者报告 RR 相关临床知识有显著提高。更重要的是,RR 相关的自主性(前均值:2.12,后均值:4.4)、能力(前均值:2.15,后均值:4.4)和关联性(前均值:2.65,后均值:4.5)的个体感知有显著增强(p < 0.01)。整体教育效果的评估结果显示平均得分为 4.69 ± 0.79。所有分数均基于 1 分至 5 分的李克特量表,1 分表示差,5 分表示优。教育者注意到了良好的参与者参与度。根据反馈,对计划的结构、评估和数据管理进行了修改。

结论

我们成功地基于自我决定理论为床边医护人员开发并实施了有针对性的教育计划。评估显示,培训后床边医护人员的临床 RR 知识和自主性、能力和关联性感知有所提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58c3/6292372/1f845948b50e/ZMEO_A_1551028_F0001_OC.jpg

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