Hakemi Ahmad, Blamoun John, Lundahl Andrew, Armstead Teresa, Hakemi Kelvin, Malik Mishaal
College of Health Professions, Central Michigan University, Mount Pleasant, MI, 48859, USA.
Clinical Education, College of Medicine, Central Michigan University, Mount Pleasant, MI, 48859, USA.
Adv Med Educ Pract. 2023 Feb 10;14:101-107. doi: 10.2147/AMEP.S398013. eCollection 2023.
The broad goal of this educational curriculum is utilization and optimization of Simulation-Based Education (SBE) in the training of residents, medical students, and nursing staff involved in the rapid and timely recognition of Anaphylaxis and its optimized treatment. A critical gap in Anaphylaxis Diagnosis, Management, and Treatment (ADAM) has been well established across medical disciplines. It is imperative to include all members of the healthcare team, as nurses and pharmacists play key roles in anaphylaxis recognition and care. Nurses and pharmacists are proficiently trained in the initial assessment of acute patient complaints, status, and in proper dosing/administration considerations. Anaphylaxis is a High Acuity and Low Occurrence (HALO) event. Delayed recognition and administration of epinephrine-autoinjector (EAI) is a patient safety concern. Suboptimal technique and expertise in this regard is common. Literature abounds with reports of physician trainee doubts and uncertainties in the recognition and optimized management of Anaphylaxis. Importantly, Anaphylaxis is frequently misdiagnosed in hospital emergency departments. SBE methodologies are ideal for instructing HALO experiences. The framework of the "Zone of Simulation Matrix" supports the utilization of a simulation experience in this instance. Learning will be effective, enhanced, and made durable by embedding numerous specifically curated educational theories. Given the paucity in training of residents and nursing staff in Anaphylaxis, such instruction is imperative. Of note, a special emphasis in this curricular framework is the debriefing experience. Considerations will be given to the psychological safety of the trainees and the importance of the heterogeneity of prior experiences. Precise diagnosis minimizes mortality. In the hospital setting, nurses are the first responders to critical HALO events, and there is a lack of awareness of ADAM by nursing students.
本教育课程的广泛目标是在培训住院医师、医学生以及参与快速及时识别过敏反应及其优化治疗的护理人员时，利用并优化基于模拟的教育（SBE）。过敏反应诊断、管理和治疗（ADAM）方面的一个关键差距在各医学学科中已得到充分证实。将医疗团队的所有成员纳入其中至关重要，因为护士和药剂师在过敏反应的识别和护理中发挥着关键作用。护士和药剂师在对急性患者投诉、状况的初始评估以及正确的剂量/给药考量方面接受了专业培训。过敏反应是一种高敏锐度和低发生率（HALO）事件。延迟识别和使用肾上腺素自动注射器（EAI）是一个患者安全问题。在这方面，技术欠佳和专业知识不足的情况很常见。文献中有大量关于医师学员在过敏反应的识别和优化管理方面存在疑问和不确定性的报道。重要的是，过敏反应在医院急诊科经常被误诊。SBE方法非常适合指导HALO体验。在这种情况下，“模拟矩阵区域”框架支持模拟体验的利用。通过融入众多经过专门策划的教育理论，学习将更有效、更深入且更持久。鉴于住院医师和护理人员在过敏反应方面的培训匮乏，这种指导势在必行。值得注意的是，本课程框架特别强调汇报环节。将考虑学员的心理安全以及先前经验异质性的重要性。准确的诊断可将死亡率降至最低。在医院环境中，护士是关键HALO事件的第一响应者，而护理专业学生对ADAM缺乏认识。
