Komasawa Nobuyasu
Community Medicine Education Promotion Office, Faculty of Medicine Kagawa University Ikenobe Kita-gun Kagawa Japan.
Acute Med Surg. 2023 Dec 27;10(1):e913. doi: 10.1002/ams2.913. eCollection 2023 Jan-Dec.
Sedation for invasive procedures is given for various clinical purposes to patients of all ages worldwide. However, sedation is a continuum to general anesthesia and contains severe inherent risks leading to mortality. Providing a simulation-based sedation training course (SEDTC) to various medical staff could be an effective strategy to improve patient and medical safety associated with sedation. The SEDTC generally includes basic airway management such as upper airway obstruction release or rapid response action toward excessive sedation, utilizing problem-based learning or simulators. However, participation alone in the SEDTC can only achieve Level 1 (reaction) or 2 (learning) in the Kirkpatrick model. A patient safety improvement of Level 3 (transfer) or 4 (result) of the Kirkpatrick model can be achieved when all members related to sedation undergo experiential learning and reach a consensus. Accordingly, in-hospital interprofessional SEDTC focusing on a resilience approach is essential to achieve effective sedation patient safety in Level 3 or 4 of the Kirkpatrick model.
在全球范围内,为了各种临床目的,会对各年龄段的患者进行侵入性操作时的镇静。然而,镇静是通向全身麻醉的一个连续过程,且存在导致死亡的严重固有风险。为各类医务人员提供基于模拟的镇静培训课程(SEDTC)可能是提高与镇静相关的患者和医疗安全的有效策略。SEDTC通常包括基本气道管理,如解除上呼吸道梗阻或对过度镇静采取快速应对措施,采用基于问题的学习或模拟器。然而,仅参与SEDTC在柯克帕特里克模型中只能达到1级(反应)或2级(学习)。当所有与镇静相关的成员都经历体验式学习并达成共识时,才能在柯克帕特里克模型中实现3级(迁移)或4级(结果)的患者安全改善。因此,专注于复原力方法的院内跨专业SEDTC对于在柯克帕特里克模型的3级或4级实现有效的镇静患者安全至关重要。