Mand Nadine, Hoffmann Marieke, Schwalb Anja, Leonhardt Andreas, Sassen Martin, Stibane Tina, Maier Rolf Felix, Donath Carolin
Neonatology and Paediatric Intensive Care, Department of Paediatrics, Philipps-University Marburg, 35043 Marburg, Germany.
Department of Paediatric Surgery, Philipps-University Marburg, 35037 Marburg, Germany.
Children (Basel). 2024 Jun 27;11(7):776. doi: 10.3390/children11070776.
(1) Background: To improve the quality of emergency care for children, the Hessian Ministry for Social Affairs and Integration offered paediatric simulation-based training (SBT) for all children's hospitals in Hesse. We investigated the quality of paediatric life support (PLS) in simulated paediatric resuscitations before and after SBT. (2) Methods: In 2017, a standardised, high-fidelity, two-day in-house SBT was conducted in 11 children's hospitals. Before and after SBT, interprofessional teams participated in two study scenarios (PRE and POST) that followed the same clinical course of apnoea and cardiac arrest with a shockable rhythm. The quality of PLS was assessed using a performance evaluation checklist. (3) Results: 179 nurses and physicians participated, forming 47 PRE and 46 POST interprofessional teams. Ventilation was always initiated. Before SBT, chest compressions (CC) were initiated by 87%, and defibrillation by 60% of teams. After SBT, all teams initiated CC ( = 0.012), and 80% defibrillated the patient ( = 0.028). The time to initiate CC decreased significantly (PRE 123 ± 11 s, POST 76 ± 85 s, = 0.030). (4) Conclusions: The quality of PLS in simulated paediatric cardiac arrests with shockable rhythm was poor in Hessian children's hospitals and improved significantly after SBT. To improve children's outcomes, SBT should be mandatory for paediatric staff and concentrate on the management of shockable rhythms.
（1）背景：为提高儿童急诊护理质量，黑森州社会事务与融合部为黑森州所有儿童医院提供了基于模拟培训（SBT）的儿科培训。我们调查了SBT前后模拟儿科复苏中儿科生命支持（PLS）的质量。（2）方法：2017年，11家儿童医院开展了为期两天的标准化、高保真内部SBT培训。在SBT前后，跨专业团队参与了两个研究场景（PRE和POST），这两个场景遵循相同的呼吸暂停和可电击心律的心脏骤停临床过程。使用绩效评估清单评估PLS的质量。（3）结果：179名护士和医生参与其中，组成了47个PRE和46个POST跨专业团队。通气总是会启动。在SBT之前，87%的团队开始进行胸外按压（CC），60%的团队进行除颤。在SBT之后，所有团队都开始进行CC（P = 0.012），80%的团队对患者进行了除颤（P = 0.028）。开始CC的时间显著缩短（PRE为123±11秒，POST为76±85秒，P = 0.030）。（4）结论：在黑森州儿童医院，模拟可电击心律的儿科心脏骤停中PLS的质量较差，SBT后有显著改善。为改善儿童的治疗结果，SBT应成为儿科工作人员的必修课，并专注于可电击心律的管理。
