评估在坦桑尼亚的SAFE产科课程后的实践变化:一项前性队列研究
M Lilaonitkul1, A Zacharia2, T J Law3
1Department of Anesthesia and Peri-operative Care, University of California San Francisco, California, USA.
Anaesthesia
|July 11, 2023
概括
从教育中获得更安全的麻醉 (SAFE) 产科培训显著改善了坦桑尼亚非医生麻醉师的临床实践. 在培训后12个月内,患者护理中的这些积极变化持续了12个月.
科学领域:
- 医学教育 医学教育
- 麻醉学 麻醉学
- 全球健康 全球健康
背景情况:
- 麻醉在资源较低的环境中对孕产妇死亡率作出了重大贡献.
- 坦桑尼亚面临着高的孕产妇死亡率,麻醉通常由非医生麻醉师提供,缺乏支持和持续教育.
- 从教育中获得更安全的麻醉 (SAFE) 课程是为了解决产科麻醉培训中的这些关键缺口而开发的.
研究的目的:
- 评估SAFE产科培训计划在提高患者安全方面的有效性.
- 评估从SAFE课程中获得的知识转化为实际的临床行为.
- 确定非医生麻醉师在12个月内改善实践的可持续性.
主要方法:
- 在坦桑尼亚的 Mbeya 地区,为 75 名非医生麻醉师提供了两个含有复习培训的 SAFE 产科课程.
- 使用二进制检查清单进行直接观察,评估剖腹产期间的外科管理.
- 在320个涉及35名参与者的病例中,在培训前,培训后立即以及培训后6个月和12个月进行了观察.
主要成果:
- 在手术前的患者评估 (32%至88%) 和检查功能吸管 (73%至85%) 中观察到显著的改善.
- 无菌脊柱技术的使用从67%增加到100%,及时预防性抗生素的使用从66%增加到95%.
- 检查脊柱阻塞的充分性从32%提高到71%,所有观察到的改善都在训练后12个月内持续下去.
结论:
- 在SAFE产科培训中,在非医生麻醉师的临床实践中表现出积极和持续的变化.
- 这些发现支持在剖腹产期间制定特定的麻醉检查清单,以提高护理质量.
- 该研究强调了有针对性的现役培训对改善资源有限的环境中的麻醉安全性的影响.
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