Gable Brad D, Hommema Laurie
System Medical Director, Simulation, Riverside Methodist Hospital, Columbus, USA.
Medical Director, Provider and Associate Well-Being, Ohio Health Associate Program Director, Riverside Family Medicine Residency, OhioHealth, Columbus, USA.
Cureus. 2021 Apr 6;13(4):e14315. doi: 10.7759/cureus.14315.
Background Medical emergencies can present to family medicine offices. For optimal patient outcomes, multiple team members must come together to provide emergency care and mobilize the appropriate resources. In-situ simulation has been used to improve provider knowledge, skills, and attitudes as well as identify latent safety threats. The aim of this training was to provide family medicine physicians, nurses, and office staff education about how to manage in-office emergencies. Specifically, we sought to clarify team members' roles, improve communication, and identify latent safety threats. Methodology Two different in-situ simulations were performed with debriefing sessions. The first was a pediatric patient in respiratory distress. The second was a patient who presented for shortness of breath and became unresponsive in the lobby. Physicians, nurses, and office staff responded to the emergencies and used existing equipment and protocols to medically manage each patient. A standardized return on investment in learning survey evaluating the learners' confidence in managing in-office emergencies was completed by all learners immediately prior to and after the training. Results The training improved the participants' self-reported confidence in their ability to manage in-office emergencies. Additionally, participants believed they were better able to identify other team members' roles when responding to an in-office emergency. Learners were able to identify where knowledge gaps existed in current protocols, as well as aspects of the protocols that required updating. Lastly, the teams identified latent safety threats that were able to be mitigated by the practice. Conclusions In-situ simulation for high-risk, low-frequency in-office emergencies is a valuable tool to improve team members' confidence, identify knowledge gaps, and mitigate latent safety threats.
背景 医疗紧急情况可能出现在家庭医学诊所。为了实现最佳的患者治疗效果，多个团队成员必须共同协作提供紧急护理并调动适当的资源。现场模拟已被用于提高医疗服务提供者的知识、技能和态度，以及识别潜在的安全威胁。本次培训的目的是为家庭医学医生、护士和办公室工作人员提供关于如何处理诊所内紧急情况的教育。具体而言，我们旨在明确团队成员的角色、改善沟通并识别潜在的安全威胁。方法 进行了两次不同的现场模拟并开展了总结汇报环节。第一次是一名患有呼吸窘迫的儿科患者。第二次是一名因呼吸急促前来就诊并在大厅失去意识的患者。医生、护士和办公室工作人员对这些紧急情况做出反应，并使用现有的设备和方案对每位患者进行医疗处理。所有学习者在培训前后立即完成了一项标准化的学习投资回报率调查，评估他们对处理诊所内紧急情况的信心。结果 培训提高了参与者自我报告的处理诊所内紧急情况的能力信心。此外，参与者认为他们在应对诊所内紧急情况时能更好地识别其他团队成员的角色。学习者能够识别当前方案中存在的知识差距以及需要更新的方案方面。最后，团队识别出了可通过该实践减轻的潜在安全威胁。结论 针对诊所内高风险、低频率的紧急情况进行现场模拟是提高团队成员信心、识别知识差距和减轻潜在安全威胁的宝贵工具。
