Division of Cardiology, Department of Medicine, NYU Langone Medical Center, New York, NY 10016, United States.
Division of Cardiology, Department of Medicine, NYU Langone Medical Center, New York, NY 10016, United States.
J Crit Care. 2021 Feb;61:14-17. doi: 10.1016/j.jcrc.2020.09.035. Epub 2020 Oct 3.
The COVID-19 surge required the deployment of large numbers of non-intensive care providers to assist in the management of the critically ill. Institutions took a variety of approaches to "uptraining" such providers though studies describing methods and effectiveness are lacking.
One hundred and seventy-five providers underwent a 3 h simulation-based session focused on management of shock, mechanical ventilation, acute respiratory distress syndrome, and critical care ultrasound. All participants were sent surveys to assess their comfort with various aspects of critical care following return to their usual work environments.
One hundred and eight providers of 175 (62%) completed the survey. Overall, 104/108 responders (96%) felt training either significantly or somewhat improved their knowledge in the management of ICU patients. Responders felt most comfortable in the management of hypoxemia in intubated patients and the management of ventilated patients with acute respiratory distress syndrome (93% strongly agree or agree, and 86% strongly agree or agree, respectively). Fewer responders felt more comfortable using focused echocardiography (70% strongly agree or agree) and lung ultrasonography in following progression of COVID-19 (76% strongly agree or agree).
Simulation-based training improved provider comfort in the management of critically ill patients with COVID-19.
新冠疫情的爆发需要大量非重症监护专业人员来协助重症患者的管理。各机构采取了各种方法来对这些人员进行“强化培训”,但缺乏描述这些方法和效果的研究。
175 名医护人员参加了一个 3 小时的基于模拟的培训课程,内容涵盖休克管理、机械通气、急性呼吸窘迫综合征和重症监护超声。所有参与者在返回日常工作环境后都被发送了一份调查,以评估他们对重症护理各个方面的舒适度。
在 175 名参与者中,有 108 名(62%)完成了调查。总体而言,104/108 名(96%)受访者认为培训显著或在一定程度上提高了他们对 ICU 患者管理的知识。受访者在处理插管患者的低氧血症和急性呼吸窘迫综合征患者的通气管理方面最有信心(93%强烈同意或同意,86%强烈同意或同意)。较少的受访者在使用聚焦超声心动图(70%强烈同意或同意)和肺超声在 COVID-19 进展时(76%强烈同意或同意)更有信心。
基于模拟的培训提高了医护人员对 COVID-19 重症患者管理的舒适度。