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实施模拟教育对医护人员进行 COVID-19 鼻咽拭子采样舒适度的影响。

Effect of Implementing Simulation Education on Health Care Worker Comfort With Nasopharyngeal Swabbing for COVID-19.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA.

出版信息

Otolaryngol Head Neck Surg. 2020 Aug;163(2):271-274. doi: 10.1177/0194599820933168. Epub 2020 Jun 2.

Abstract

OBJECTIVE

To determine if rapid implementation of simulation training for the nasopharyngeal swab procedure can increase provider confidence regarding procedure competency.

METHODS

A simulation training exercise was designed as a departmental initiative to improve competency performing nasopharyngeal swabs during the COVID-19 pandemic. Sixty-one health care workers attended teaching sessions led by the Department of Otorhinolaryngology on proper nasopharyngeal swab technique. After a brief lecture, participants practiced their swab technique using a high-fidelity airway simulation model. Pre- and postintervention self-evaluations were measured via standardized clinical competency questionnaires on a 5-point Likert scale ranging from "No knowledge, unable to perform" up to "Highly knowledgeable and confident, independent."

RESULTS

Forty-six participants in this study submitted pre- and postintervention self-assessments. Postintervention scores improved on average 1.41 points (95% CI, 1.10-1.73) out of 5 from a mean score of 3.13 to 4.54 ( < .0001). This reflects a large effect size with a Glass's delta value of 1.3.

DISCUSSION

Lecture coupled with simulation-based teaching can significantly improve health care workers' confidence in performing nasopharyngeal swabs. Proper training for frontline workers performing swabs for COVID-19 is essential to improving testing accuracy and can be achieved in a simple and timely manner.

IMPLICATIONS FOR PRACTICE

To meet the testing needs of the growing pandemic, many health care workers who are unfamiliar with nasopharyngeal swabs have been asked to perform this test. Simulation-based teaching sessions may improve health care workers' confidence and help prevent false-negative results. This intervention is easily reproducible in any setting where frequent nasopharyngeal swab testing occurs.

LEVEL OF EVIDENCE/STUDY DESIGN: Prospective cohort study.

摘要

目的

确定鼻咽拭子操作的模拟培训能否快速提高医护人员对该操作的熟练度。

方法

本模拟培训是耳鼻喉科发起的一项部门倡议,旨在提高医护人员在新冠疫情期间进行鼻咽拭子检测的熟练度。61 名医护人员参加了由耳鼻喉科组织的关于正确鼻咽拭子技术的教学课程。在简短的讲座后,参与者使用高保真气道模拟模型练习了他们的拭子技术。通过标准化的临床能力问卷,在 5 分制的李克特量表上对干预前后的自我评估进行测量,范围从“无知识,无法执行”到“高度知识渊博和自信,独立”。

结果

本研究共有 46 名参与者提交了干预前后的自我评估。干预后,平均分数从 3.13 分提高到 4.54 分,提高了 1.41 分(95%CI,1.10-1.73)(<0.0001)。这反映了一个较大的效应量,Glass's delta 值为 1.3。

讨论

讲座结合基于模拟的教学可以显著提高医护人员进行鼻咽拭子操作的信心。对进行新冠病毒检测的一线工作人员进行适当的培训对于提高检测的准确性至关重要,而且可以以简单、及时的方式实现。

实践意义

为了满足不断增长的大流行检测需求,许多不熟悉鼻咽拭子的医护人员被要求进行这项检测。基于模拟的教学课程可以提高医护人员的信心,并有助于防止假阴性结果。这种干预措施在任何经常进行鼻咽拭子检测的地方都很容易复制。

证据水平/研究设计:前瞻性队列研究。

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