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分析在 COPD 加重患者应用无创通气中的共同认知任务。

Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation.

机构信息

Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago.

Center for Innovations in Chronic, Complex Healthcare, Edward Hines JR VA Medical Center, Hines.

出版信息

J Interprof Care. 2023 Jul-Aug;37(4):576-587. doi: 10.1080/13561820.2022.2118681. Epub 2022 Oct 20.

Abstract

Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview ( = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.

摘要

跨专业团队合作在采用基于证据的干预措施方面发挥着关键作用,例如慢性阻塞性肺疾病(COPD)加重患者的无创通气(NIV)。我们旨在使用 COPD 加重患者 NIV 的方法来确定跨专业团队的共同认知任务。我们使用认知任务分析方法(CTA)来吸引参与 NIV 治疗 COPD 加重患者的护士、快速反应小组成员、呼吸治疗师和医生。临床医生参与了一项半结构化访谈(n = 21),以引出治疗 COPD 加重所需的认知。确定了三个共同的认知任务:完成全面评估、制定护理计划和持续监测患者状况。研究结果证明了获得最新信息和专业知识的重要性,这对于进行准确的临床推断以进行患者评估至关重要。护理团队所有成员对制定的护理计划的共同理解对于其实施很重要。持续监测至关重要;但是,此认知任务取决于患者评估技能和临床护理团队内的持续协作。对于 COPD 加重患者应用 NIV 可能需要通过非技术技能和跨专业培训来增强协作。

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