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用于对工作人员进行谵妄检测教育的重症监护病房视频系列的开发与评估

Development and Evaluation of an Intensive Care Unit Video Series to Educate Staff on Delirium Detection.

作者信息

Kamdar Biren B, Makhija Hirsh, Cotton Shannon A, Fine Janelle, Pollack Daniel, Reyes Paola Alicea, Novelli Francesca, Malhotra Atul, Needham Dale M, Martin Jennifer L

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine.

Division of Biological Sciences, University of California San Diego, La Jolla, California.

出版信息

ATS Sch. 2022 Sep 23;3(4):535-547. doi: 10.34197/ats-scholar.2022-0011OC. eCollection 2022 Dec.

Abstract

BACKGROUND

Delirium affects up to 80% of patients who are mechanically ventilated in the intensive care unit (ICU) but often goes undetected because of incomplete and/or inaccurate clinician evaluation and documentation. A lack of effective, feasible, and sustainable educational methods represents a key barrier to efforts to optimize, scale, and sustain delirium detection competencies. Progress with such barriers may be addressed with asynchronous video-based education.

OBJECTIVE

To evaluate a novel ICU Delirium Video Series for bedside providers via a knowledge assessment quiz and a feedback questionnaire.

METHODS

An interdisciplinary team scripted and filmed an educational ICU Delirium Video Series, providing detailed instruction on delirium detection using the validated CAM-ICU (Confusion Assessment Method for the ICU). A cohort of bedside nurses subsequently viewed and evaluated the ICU Delirium Video Series using a feedback questionnaire and a previously developed knowledge assessment quiz pre- and post-video viewing.

RESULTS

Twenty nurses from four ICUs viewed the ICU Delirium Video Series and completed the pre-post quiz and questionnaire. Ten (50%) respondents had 10 or more years of ICU experience, and seven (35%) reported receiving no CAM-ICU education locally. After video viewing, overall pre-post scores improved significantly (66% vs. 79%;  < 0.0001). In addition, after video viewing, more nurses reported comfort in their ability to evaluate and manage patients with delirium.

CONCLUSION

Viewing the ICU Delirium Video Series resulted in significant improvements in knowledge and yielded valuable feedback. Asynchronous video-based delirium education can improve knowledge surrounding a key bedside competency.

摘要

背景

谵妄影响着多达80%在重症监护病房(ICU)接受机械通气的患者,但由于临床医生评估和记录不完整及/或不准确,谵妄常常未被发现。缺乏有效、可行且可持续的教育方法是优化、扩大和维持谵妄检测能力的关键障碍。通过基于视频的异步教育可能有助于克服这些障碍。

目的

通过知识评估测验和反馈问卷评估一种新颖的针对床边医护人员的ICU谵妄视频系列。

方法

一个跨学科团队编写并拍摄了一个关于ICU谵妄的教育视频系列,使用经过验证的CAM-ICU(ICU谵妄评估方法)提供关于谵妄检测的详细指导。随后,一组床边护士使用反馈问卷以及在观看视频前后使用先前开发的知识评估测验来观看和评估ICU谵妄视频系列。

结果

来自四个ICU的20名护士观看了ICU谵妄视频系列并完成了前后测验和问卷。10名(50%)受访者有10年或以上的ICU工作经验,7名(35%)报告在当地未接受过CAM-ICU教育。观看视频后,总体前后得分显著提高(66%对79%;<0.0001)。此外,观看视频后更多护士表示对评估和管理谵妄患者的能力更有信心。

结论

观看ICU谵妄视频系列使知识有显著提高并产生了有价值的反馈。基于视频的异步谵妄教育可以提高围绕一项关键床边技能方面的知识。

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