外在负荷,患者普查和患者敏度与ICU循环期间的认知负荷相关
Natalie Held1, Anna Neumeier1, Timothy Amass1
1Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado School of Medicine, Aurora, CO.
Chest
|January 6, 2024
概括
在重症监护室 (ICU) 巡回中,高认知负载与外来事件,新患者和患者敏度的增加有关. 优化ICU圆形结构可以减少提供者的工作量,提高学习和绩效.
科学领域:
- 医学教育 医学教育
- 医疗保健操作 医疗保健操作
- 认知心理学 认知心理学
背景情况:
- 认知负载理论解释了过度的精神努力如何损害学习和表现.
- 重症监护室 (ICU) 轮次呈现出高度压力,复杂的环境与众多的认知分心.
- 在这些挑战中,ICU中的多学科团队必须平衡决策,教学和患者护理.
研究的目的:
- 识别与高提供者的认知负载相关的ICU轮的特征.
- 调查外在认知负载事件与ICU轮期间感知工作负载之间的关系.
- 为了告知ICU圆形结构的潜在修改,以减轻认知负担.
主要方法:
- 一项观察性多站点研究,涉及多学科的ICU提供者.
- 每小时记录一次外来认知负载事件 (分心,注意力分裂,重复,沟通偏差).
- 提供者的认知负载是使用提供者任务负载 (PTL) 调查进行的,该调查是根据美国宇航局的任务负载指数进行的.
- 混合效应建模分析了圆形特征,外部负载和PTL分数之间的关联.
主要成果:
- 共有76名医疗服务提供者参加了32轮ICU治疗.
- 平均外部认知负载为每小时20.5次 (每2分51秒发生一次).
- 较高的每小时外在负载事件,更多的新患者和患者敏度的增加与较高的PTL得分有显著的关联.
结论:
- 增加的外部认知负载,新患者的数量和患者的敏度是导致ICU轮期间认知负载高的关键因素.
- 这些发现表明,修改ICU圆形结构可以帮助减少提供者的工作量.
- 优化这些结构有可能改善提供者学习和临床表现.
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