Department of Medicine, University of Cincinnati, Cincinnati, Ohio.
Department of Pulmonary and Critical Care, Riverside Health System, Newport News, Virginia.
J Am Assoc Nurse Pract. 2021 Mar 12;33(12):1116-1119. doi: 10.1097/JXX.0000000000000574.
Nurse practitioners (NPs) and physician assistants (PA) are increasingly providing care to the critically ill patients in the intensive care unit. We structured a 4-month training program for our existing NPs and PAs and assessed their knowledge and skill pre and post training. The program was composed of blended didactic in critical care medicine topics, critical care simulations in simulation laboratory, and supervised critical care procedures. Formal knowledge and skill assessments were performed before and after the program to assess success in meeting predefined learning objectives. The mean preintervention medical knowledge assessment score was 3.37 ± 0.56 SD, which significantly improved to 3.86 ± 0.46 SD (p < .00001). For clinical skills for critical care procedures, the mean preintervention score was 3.10 ± 0.86 SD, which improved to 3.61 ± 0.92 SD (p < .00001). The overall knowledge (including medical knowledge and clinical skills) improved from mean 3.30 ± 0.86 SD to 3.80 ± 0.42 SD. The improvement was seen regardless of the duration of experience in critical care medicine. We concluded that structured didactics with supervised procedural training along with dedicated training in simulation laboratories, even for a short period, improves the overall knowledge and clinical skills required to work in a critical care setting.
护士从业者(NPs)和医师助理(PA)越来越多地为重症监护病房的重症患者提供护理。我们为现有的 NPs 和 PA 构建了一个为期 4 个月的培训计划,并在培训前后评估了他们的知识和技能。该计划由混合式重症医学课程、模拟实验室中的重症监护模拟以及监督性重症监护程序组成。在计划前后进行正式的知识和技能评估,以评估在满足预定学习目标方面的成功。干预前医学知识评估的平均分数为 3.37 ± 0.56 SD,显著提高至 3.86 ± 0.46 SD(p <.00001)。对于重症监护程序的临床技能,干预前的平均分数为 3.10 ± 0.86 SD,提高至 3.61 ± 0.92 SD(p <.00001)。总体知识(包括医学知识和临床技能)从平均 3.30 ± 0.86 SD 提高到 3.80 ± 0.42 SD。无论在重症监护医学方面的经验长短,都可以看到这种提高。我们得出结论,即使是短期的,有组织的教学与监督性程序培训以及专门的模拟实验室培训,都可以提高在重症监护环境中工作所需的整体知识和临床技能。