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香港一家地区医院针对新冠疫情期间气管插管的多学科模拟培训:强化现有程序与准备工作。

Multidisciplinary simulation training for endotracheal intubation during COVID-19 in one Hong Kong regional hospital: strengthening of existing procedures and preparedness.

作者信息

So Eric H K, Chia N H, Ng George W Y, Chan Osburga P K, Yuen S L, Lung David C, Li W C, So S S, Cheung Victor K L

机构信息

Multi-Disciplinary Simulation and Skills Centre (MDSSC), Queen Elizabeth Hospital, Hospital Authority, Kowloon, Hong Kong.

Quality & Safety Department, Hospital Authority Kowloon Central Cluster, Kowloon, Hong Kong.

出版信息

BMJ Simul Technol Enhanc Learn. 2021 May 25;7(6):501-509. doi: 10.1136/bmjstel-2020-000766. eCollection 2021.

Abstract

INTRODUCTION

In early 2020, our hospital responded with high alertness when novel coronavirus SARS-CoV-2 appeared. A hospital-based training programme was rapidly arranged to prepare staff for the imminent threat.

OBJECTIVE

We developed a hospital-wide multidisciplinary infection control training programme on endotracheal intubation for healthcare workers to minimise nosocomial spread of COVID-19 during this high-stress and time-sensitive risky procedure.

METHODOLOGY

Major stakeholders (Quality & Safety Department, Infection Control Team, Central Nursing Division, high-risk clinical departments and hospital training centre) formed a training programme task group. This group was tasked with developing high-fidelity scenario-based simulation training curriculum for COVID-19 endotracheal intubation with standard workflow and infection control practice. This group then implemented and evaluated the training programme for its effectiveness.

RESULTS

101 training classes of 2-hour session were conducted from 5 February to 18 March 2020, involving 1415 hospital staff (~81% of target participants with training needs) either inside the hospital training centre or as in situ simulation training (intensive care unit or accident and emergency department). Learners' satisfaction was reflected by overall positive response percentage at 90%. Opinions of participating staff were incorporated into the standard airway management and infection control practice for endotracheal intubation of adult patients with COVID-19. Thirty-five patients with COVID-19 were intubated with the current workflow and guideline without any nosocomial transmission.

CONCLUSION

An early planned and well-structured multidisciplinary hospital-wide simulation training programme was organised expeditiously to provide extensive staff coverage. The insight and experience gained from this project is valuable for future infectious disease challenges.

摘要

引言

2020年初,新型冠状病毒SARS-CoV-2出现时,我院迅速做出高度警惕的反应。迅速安排了一项基于医院的培训计划,让工作人员做好应对迫在眉睫威胁的准备。

目的

我们为医护人员制定了一项全院范围的关于气管插管的多学科感染控制培训计划,以在这一高压力且时间紧迫的风险操作过程中尽量减少COVID-19的医院内传播。

方法

主要利益相关者(质量与安全部门、感染控制团队、中央护理部、高风险临床科室和医院培训中心)组成了一个培训计划任务组。该小组负责为COVID-19气管插管制定基于高保真情景模拟的培训课程,包括标准工作流程和感染控制实践。然后该小组实施并评估了培训计划的有效性。

结果

2020年2月5日至3月18日共举办了101节时长为2小时的培训课程,涉及1415名医院工作人员(约占培训需求目标参与者的81%),培训地点在医院培训中心或进行现场模拟培训(重症监护病房或急诊科)。学习者的满意度通过90%的总体积极反馈率得以体现。参与培训的工作人员的意见被纳入到成人COVID-19患者气管插管的标准气道管理和感染控制实践中。35例COVID-19患者按照当前的工作流程和指南进行了气管插管,未发生任何医院内传播。

结论

迅速组织了一项早期规划且结构完善的全院范围多学科模拟培训计划,以覆盖广泛的工作人员。从该项目中获得的见解和经验对未来应对传染病挑战具有重要价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7b8/8936740/05de5145399d/bmjstel-2020-000766f01.jpg

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