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采用临床模拟方法对新冠病毒感染孕妇护理管理方案进行分析并提出改进建议。

Analysis of the care management protocol for COVID pregnant women and detection of improvement proposals applying clinical simulation methodology.

作者信息

González A M, Hernández Pinto P, Maldonado S, Villalobos I, Sierra N, Melgosa I

机构信息

Unidad de Anestesia Materno-Infantil, Servicio de Anestesiología y Reanimación, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro Salud, Santander, Cantabria, España.

Unidad de Anestesia Materno-Infantil, Servicio de Anestesiología y Reanimación, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro Salud, Santander, Cantabria, España.

出版信息

Rev Esp Anestesiol Reanim (Engl Ed). 2020 Nov;67(9):487-495. doi: 10.1016/j.redar.2020.07.010. Epub 2020 Oct 6.

Abstract

INTRODUCTION

The current SARS-CoV-2 pandemic has been the world's largest socio-health crisis experienced in the last century. Each healthcare center has been compelled to adapt the treatment guidelines established by the different scientific societies.

OBJECTIVES

Analyze the impact of the methodology based on simulation as a tool to improve our clinical practice: work dynamics, effectiveness and safety of all the physicians involved in the management of labor in COVID pregnant women and its usefulness to facilitate the adaptation of protocols to a specific clinical context.

METHOD

Descriptive observational study that includes the C-sections and deliveries of COVID pregnant women performed in our hospital. The actions carried out in each procedure were analyzed using the simulation multidisciplinary briefing and debriefing tools, before and after each case.

RESULTS

A total of 5 clinical cases were analyzed. Difficulties were found in the execution of the protocols established for the care of the COVID pregnant. Organizational, structural, material resources and human factors obstacles were the most common.

CONCLUSIONS

Our results showed that the analysis example using simulation methodology was a tool of great value in three aspects: teamwork improvement, actions consent and improvement proposals for the adaptation and implementation of protocols.

摘要

引言

当前的新冠病毒大流行是上个世纪以来全球经历的最大的社会健康危机。每个医疗中心都不得不调整不同科学协会制定的治疗指南。

目的

分析基于模拟的方法作为一种改善我们临床实践的工具所产生的影响:新冠病毒感染孕妇分娩管理中所有医生的工作动态、有效性和安全性,以及其对促进方案适用于特定临床环境的作用。

方法

描述性观察性研究,纳入我院进行的新冠病毒感染孕妇剖宫产和分娩病例。在每个病例前后,使用模拟多学科简报和汇报工具分析每个手术过程中采取的行动。

结果

共分析了5例临床病例。发现为新冠病毒感染孕妇制定的护理方案在执行过程中存在困难。组织、结构、物质资源和人为因素障碍最为常见。

结论

我们的结果表明,使用模拟方法进行分析的实例在三个方面具有重要价值:改善团队协作、行动共识以及为方案的调整和实施提出改进建议。

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本文引用的文献

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Using clinical simulation to study how to improve quality and safety in healthcare.利用临床模拟研究如何提高医疗保健的质量和安全性。
BMJ Simul Technol Enhanc Learn. 2020 Mar 4;6(2):87-94. doi: 10.1136/bmjstel-2018-000370. Epub 2018 Sep 29.

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