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[针对重症患者护理的卫生专业人员培训模式评估:AIPCAP研究]

[Evaluation of a training model for health professionals in the care of critical patients: AIPCAP Study].

作者信息

Cánovas Zaldúa Yoseba, Casabella Abril Bartomeu, Martín Cantera Carlos, González García Fernando, Moreno Escribá Sonia, Del Val García José Luis

机构信息

Centro de Atención Primaria Passeig de Sant Joan, Barcelona, España.

Centro de Atención Primaria Raval Sud, Barcelona, España.

出版信息

Aten Primaria. 2020 Mar;52(3):151-158. doi: 10.1016/j.aprim.2018.08.009. Epub 2019 Jan 10.

Abstract

OBJECTIVE

To evaluate the validity, acceptability, and impact on the level of knowledge and skills of Primary Care health professionals of a training model aimed at improving the care of critical patients.

DESIGN

A quasi-experimental interventional, multicentre study.

LOCATION

Eight health care teams in Barcelona.

PARTICIPANTS

A total of 272 professionals.

INTERVENTIONS

A training program consisting of 48 simulations of acute myocardial infarction and stroke.

MAIN MEASUREMENTS

A checklist was used to evaluate critical patient skills, effect of training on the knowledge of the participants, and a satisfaction survey. The training was carried out after 2 series of simulations (AMI+Stroke). In the second series, 3evaluations were made: in situ, one week after, and at 3weeks. Concordance and reliability were measured. The differences in means were analysed using the Student t test for paired data.

RESULTS

A total of 449 knowledge tests were answered, with a higher score being obtained at the end of each simulation (3.89 -SD 1.01 vs. 3.21 -SD 1.09). Doctors obtained better medical scores than nurses (3.81 - SD 0.87 vs. 3.32 - SD 1.15), and professionals with a specialty completed scored more than those in training (MIR) (3.6 - SD 1.08 vs. 3.4 - SD 1.18). The mean score was 7.7 points (SD 1.56) in the first evaluation, and improved to 9.1 points (SD 0.78). The kappa index was greater than 0.40 in all cases.

CONCLUSIONS

A training methodology in the management of emergencies in Primary Care based on simulations is valid, reliable and well accepted, achieving an improvement in the level of knowledge and skills of the participating professionals.

摘要

目的

评估一种旨在改善危重症患者护理的培训模式对基层医疗保健专业人员知识和技能水平的有效性、可接受性及影响。

设计

一项准实验性干预多中心研究。

地点

巴塞罗那的八个医疗团队。

参与者

共272名专业人员。

干预措施

一个由48次急性心肌梗死和中风模拟组成的培训项目。

主要测量指标

使用一份清单来评估危重症患者护理技能、培训对参与者知识的影响以及一项满意度调查。培训在两轮模拟(急性心肌梗死+中风)后进行。在第二轮模拟中,进行了三次评估:现场评估、一周后评估和三周后评估。测量了一致性和可靠性。使用配对数据的学生t检验分析均值差异。

结果

共回答了449份知识测试,每次模拟结束时得分更高(3.89 -标准差1.01对3.21 -标准差1.09)。医生的医学得分高于护士(3.81 -标准差0.87对3.32 -标准差1.15),专科专业人员的得分高于培训中的专业人员(住院医生培训)(3.6 -标准差1.08对3.4 -标准差1.18)。首次评估的平均得分为7.7分(标准差1.56),提高到了9.1分(标准差0.78)。所有情况下kappa指数均大于0.40。

结论

基于模拟的基层医疗急救管理培训方法是有效、可靠且易于接受的,能提高参与专业人员的知识和技能水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7527/7063162/c3846425f75e/gr1.jpg

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