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一种新开发的针对新冠肺炎患者气道管理的跨专业模拟培训:挑战与安全差距的识别以及参与者反应评估

A Newly Developed Interprofessional Simulation-Based Training for Airway Management of COVID-19 Patients: Identification of Challenges and Safety Gaps, and Assessment of the Participants' Reaction.

作者信息

Sabbagh Abdulrahman Y, Alzaid Hala M, Almarshed Abdullah A, Azizalrahman Amani A, Elmasry Shady, Rosu Claudia A, Alzoraigi Usamah, Alzahrani Abdulrahman, Cluntun Ameera A

机构信息

Emergency Department, King Fahad Medical City, Riyadh, Saudi Arabia.

Center of Research, Education, Simulation, and Enhanced Training (CRESENT), King Fahad Medical City, Riyadh, Saudi Arabia.

出版信息

J Clin Med Res. 2022 Sep;14(9):377-387. doi: 10.14740/jocmr4756. Epub 2022 Sep 29.

Abstract

BACKGROUND

Healthcare providers performing aerosol-generating procedures like airway management are at the highest risk for contamination with coronavirus disease 2019 (COVID-19). We developed an simulation (ISS) airway management training in confirmed or suspected COVID-19 patients for emergency and anesthesiology staff, evaluated participants' reactions, and identified perceived challenges.

METHODS

We used a cross-sectional study design incorporating a quantitative questionnaire to describe participants' reaction to the ISS and a qualitative group interview using the plus-delta debriefing modality to explore participants' challenges in acquiring the knowledge and skills required for each learning objective. Data were analyzed using descriptive statistics and deductive content analysis.

RESULTS

Two hundred and ninety-nine healthcare providers participated in 62 ISS training sessions. Over 90% of our study participants agreed or strongly agreed that: they understood the learning objectives; the training material appropriately challenged them; the course content was relevant, easy to navigate, and essential; the facilitators' knowledge, teaching, and style were appropriate; the simulation facilities were suitable; and they had ample opportunities to practice the learned skills. The main challenges identified were anticipating difficult airways, preparing intubation equipment, minimizing the number of personnel inside the room, adhering to the proper doffing sequence, preparing needed equipment outside the intubation room, speaking up, and ensuring closed-loop communication.

CONCLUSION

The newly developed ISS training was feasible for busy healthcare practitioners to safely perform airway management procedures for suspected or confirmed COVID-19 patients without affecting bedside care. Anticipation of difficult airways and speaking up were the most frequent challenges identified across all specialties in this study.

摘要

背景

进行气道管理等产生气溶胶操作的医护人员感染2019冠状病毒病(COVID-19)的风险最高。我们为急诊和麻醉科工作人员开发了针对确诊或疑似COVID-19患者的模拟气道管理培训(ISS),评估了参与者的反应,并确定了他们察觉到的挑战。

方法

我们采用横断面研究设计,纳入一份定量问卷来描述参与者对ISS的反应,并采用“正-负”汇报模式进行定性小组访谈,以探讨参与者在获取每个学习目标所需知识和技能方面面临的挑战。使用描述性统计和演绎性内容分析法对数据进行分析。

结果

299名医护人员参加了62次ISS培训课程。超过90%的研究参与者同意或强烈同意:他们理解学习目标;培训材料对他们构成了适当的挑战;课程内容相关、易于操作且至关重要;培训师的知识、教学方法和风格合适;模拟设施适宜;并且他们有充足的机会练习所学技能。确定的主要挑战包括预判困难气道、准备插管设备、尽量减少房间内的人员数量、遵守正确的脱卸顺序、在插管室外准备所需设备、大声表达意见以及确保闭环沟通。

结论

新开发的ISS培训对于忙碌的医护人员来说是可行的,他们可以在不影响床边护理的情况下,安全地为疑似或确诊的COVID-19患者进行气道管理操作。预判困难气道和大声表达意见是本研究中所有专业领域最常出现的挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4468/9534185/cef0cf0dac30/jocmr-14-377-g001.jpg

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