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路在何方,ECMO?COVID-19 大流行期间的多学科混合体外膜肺氧合团队查房

Quo Vadis, ECMO? Multidisciplinary Hybrid Extra Corporeal Membrane Oxygenation Rounds During the COVID-19 Pandemic.

机构信息

Mayo Clinic, Phoenix, Arizona.

Mayo Clinic, Phoenix, Arizona.

出版信息

J Cardiothorac Vasc Anesth. 2024 Nov;38(11):2546-2551. doi: 10.1053/j.jvca.2024.07.049. Epub 2024 Aug 2.

Abstract

The complex care of patients on extracorporeal membrane oxygenation (ECMO) requires a high level of collaboration between multiple medical specialties and allied health professionals. Effective and timely communication between team members is imperative in ensuring patient safety. The COVID-19 pandemic posed unique challenges in the care of patients on ECMO. Communication between team members was complicated by social distancing recommendations, increased patient volume, and staff turnover. In this article, we describe a hybrid approach to rounds that allowed team members to attend virtually or in-person to improve team communication. Weekly hybrid ECMO rounds were held to discuss patient cases and work collectively to establish patient centered goals for the following week. Critical care and surgical consultants, registered nurse ECMO specialists, RNs, perfusionists, respiratory therapists, physical and occupational therapists, pharmacists, ethics committee members, and patient family members were invited to attend hybrid ECMO rounds. After eight months of rounds, medical care team members were asked to provide feedback regarding the rounds format, strengths, and weaknesses. The most frequently identified strengths were improved multidisciplinary communication and continuity of care. This article demonstrates that hybrid virtual and in-person patient rounds are a feasible way for ECMO programs to improve team communication and overall patient care.

摘要

体外膜肺氧合(ECMO)患者的复杂护理需要多个医学专业和相关医疗保健专业人员之间的高度协作。团队成员之间的有效和及时沟通对于确保患者安全至关重要。COVID-19 大流行给 ECMO 患者的护理带来了独特的挑战。团队成员之间的沟通因社会距离建议、患者数量增加和员工流动而变得复杂。在本文中,我们描述了一种混合式查房方法,允许团队成员虚拟或亲自参加,以改善团队沟通。每周举行混合式 ECMO 查房,讨论患者病例,并共同努力为下周制定以患者为中心的目标。重症监护和外科顾问、注册护士 ECMO 专家、注册护士、灌注师、呼吸治疗师、物理治疗师和职业治疗师、药剂师、伦理委员会成员和患者家属受邀参加混合式 ECMO 查房。在进行了八个月的查房后,医疗护理团队成员被要求就查房形式、优势和劣势提供反馈。最常被确定的优势是改善了多学科沟通和护理的连续性。本文表明,混合式虚拟和现场患者查房是 ECMO 项目改善团队沟通和整体患者护理的可行方法。

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