Bambi Stefano, Parente Eustachio, Bardacci Yari, Baldassini Rodriguez Samuele, Forciniti Carolina, Ballerini Lorenzo, Caruso Christian, El Aoufy Khadija, Poggianti Marta, Bonacaro Antonio, Rona Roberto, Rasero Laura, Lucchini Alberto
Department of Health Sciences, University of Florence, 50134 Florence, Italy.
Neuroscience-Neurosurgery, Meyer Children's Hospital, 50139 Florence, Italy.
Nurs Rep. 2022 Dec 27;13(1):17-28. doi: 10.3390/nursrep13010002.
Background: Noninvasive ventilation (NIV) in COVID-19 patients outside of intensive care unit (ICU) settings was a feasible support during the pandemic outbreak. The aim of this study was to assess the effectiveness of an “on the job” NIV training program provided to 66 nurses working in 3 COVID-19 wards in an Italian university hospital. Methods: A quasi-experimental longitudinal before−after study was designed. The NIV Team education program, provided by expert ICU nurses, included: 3 h sessions of training on the job during work-shifts about the management of helmet-continuous positive airway pressure (CPAP) Venturi systems, and NIV with oronasal and full-face masks. An eleven-item “brief skills self-report tool” was administered before and after the program to explore the perception of NIV education program attendees about their level of skills. Results: In total, 59 nurses responded to the questionnaire. There was an improvement in the skill levels of the management of Helmet-CPAP (median before training 2, inter-quartile range (IQR) 0−6; median after training 8, IQR 3−9; p < 0.0001), and mask-NIV (median before training 2, IQR 0−6; median after training 8, IQR 3−9; p < 0.0001). Conclusions: Training on the job performed by expert ICU nurses can be a valuable and fast means to implement new Helmet-CPAP and mask-NIV skills outside of ICUs.
在新冠疫情爆发期间，在重症监护病房（ICU）以外的环境中对新冠患者进行无创通气（NIV）是一种可行的支持措施。本研究的目的是评估为意大利一家大学医院3个新冠病房的66名护士提供的“在职”无创通气培训项目的效果。方法：设计了一项准实验性纵向前后研究。由重症监护病房专家护士提供的无创通气团队教育项目包括：在轮班期间进行3小时的在职培训，内容涉及头盔持续气道正压通气（CPAP）文丘里系统的管理，以及口鼻面罩和全面罩无创通气。在项目前后使用一份包含11个条目的“简短技能自我报告工具”，以探究无创通气教育项目参与者对其技能水平的认知。结果：共有59名护士回复了问卷。头盔持续气道正压通气管理技能水平有所提高（培训前中位数为2，四分位间距（IQR）为0 - 6；培训后中位数为8，IQR为3 - 9；p < 0.0001），面罩无创通气技能水平也有所提高（培训前中位数为2，IQR为0 - 6；培训后中位数为8，IQR为3 - 9；p < 0.0001）。结论：由重症监护病房专家护士进行的在职培训可以成为在重症监护病房以外实施新的头盔持续气道正压通气和面罩无创通气技能的一种有价值且快速的方法。
