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评估喀麦隆创伤质量改进培训课程试点后的认知转变。

Evaluating Shifts in Perception After a Pilot Trauma Quality Improvement Training Course in Cameroon.

机构信息

David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

Program for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, Los Angeles, California.

出版信息

J Surg Res. 2022 Aug;276:151-159. doi: 10.1016/j.jss.2022.02.019. Epub 2022 Mar 25.

Abstract

INTRODUCTION

Trauma is a major contributor to the global burden of disease, with low- and middle-income countries (LMICs) being disproportionately affected. Trauma Quality Improvement (QI) initiatives could potentially save an estimated two million lives each year. Successful trauma QI initiatives rely on adequate training and a culture of quality among hospital staff. This study evaluated the effect of a pilot trauma QI training course on participants' perceptions on leadership, medical errors, and the QI process in Cameroon.

METHODS

Study participants took part in a three-day, eight-module course training on trauma QI methods and applications. Perceptions on leadership, medical errors, and QI were assessed pre and post-course using a 15-item survey measured on a five-point Likert scale. Median pre- and post-course scores were compared using the Wilcoxon signed-rank test. Knowledge retention and course satisfaction were also evaluated in a post-course survey and evaluation.

RESULTS

A majority of the 25 course participants completed pre-course (92%) and post-course (80%) surveys. Participants' perceptions of safety and comfort discussing medical errors at work significantly increased post-course (pre-median = 5, IQR [4-5]; post-median = 5, IQR [5-5]; P = 0.046). The belief that individuals responsible for medical error should be held accountable significantly decreased after the course (pre-median = 3, IQR [2-4]; post-median = 1, IQR [1-2]; P < 0.001). Overall satisfaction with the course was high with median scores ≥4.

CONCLUSIONS

These initial results suggest that targeted trauma QI training effectively influences attitudes about QI. Further investigation of the effect of the trauma QI training on hospital staff in larger courses is warranted to assess reproducibility of these findings.

摘要

简介

创伤是全球疾病负担的主要因素,中低收入国家(LMICs)受到的影响不成比例。创伤质量改进(QI)计划有可能每年挽救约 200 万人的生命。成功的创伤 QI 计划依赖于医院工作人员的充分培训和质量文化。本研究评估了在喀麦隆进行的一项创伤 QI 培训课程试点对参与者对领导力、医疗错误和 QI 过程的看法的影响。

方法

研究参与者参加了为期三天的八项模块课程培训,内容是创伤 QI 方法和应用。使用五点李克特量表评估的 15 项调查,在课程前后评估对领导力、医疗错误和 QI 的看法。使用 Wilcoxon 符号秩检验比较课程前后的中位数评分。还在课程后的调查和评估中评估了知识保留和课程满意度。

结果

25 名课程参与者中的大多数完成了课前(92%)和课后(80%)调查。参与者对在工作中讨论医疗错误的安全性和舒适度的看法在课后显著增加(课前中位数=5,IQR[4-5];课后中位数=5,IQR[5-5];P=0.046)。个人对医疗错误负责的信念在课程结束后明显下降(课前中位数=3,IQR[2-4];课后中位数=1,IQR[1-2];P<0.001)。对课程的总体满意度很高,中位数评分≥4。

结论

这些初步结果表明,有针对性的创伤 QI 培训有效地影响了对 QI 的态度。需要进一步调查更大规模课程中创伤 QI 培训对医院工作人员的影响,以评估这些发现的可重复性。

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