为临床专家制定可通用的儿科ECMO紧急检查清单:进展和挑战
Jamie M Furlong-Dillard1, Kamal Abulebda2, Aaron W Calhoun1
1Division of Pediatric Critical Care, University of Louisville, Norton Children's Hospital, Louisville, KY, USA.
Perfusion
|May 29, 2024
概括
开发一种可通用的体外膜氧化 (ECMO) 技能评估方法是具有挑战性的. ECMO电路设计的变化对技能评估的可靠性产生了重大影响,这表明需要特定站点的工具或标准化.
科学领域:
- 关键护理医学 关键护理医学
- 医学教育 医学教育
- 心血管工程 心血管工程
背景情况:
- 身体外膜氧化 (ECMO) 需要专门的临床专家 (CS) 在紧急情况下进行电路管理.
- 由于不同的协议和电路设计,现有的CS技能评估工具显示出显著的差异.
- 需要一个可概括的ECMO技能评估,并为总结性评估提供强有力的有效性证据.
研究的目的:
- 开发一个可通用的ECMO技能评估工具.
- 提高现有的评估检查清单的有效性和可靠性.
- 创建一个总结性评估工具,用于ECMO电路管理的临床专家熟练程度.
主要方法:
- 经过修改的Delphi过程被用于改变现有的检查清单和基于对ECMO电路变化的调查的模拟.
- 完成的评估工具在两个机构和两个电路设计中对有效性和可靠性进行了评估.
- 三位评级人员评估了来自五个受试者的十个模拟,并使用概括性 (G) 和决策性 (D) 研究分析了数据.
主要成果:
- 该研究的概括性 (G) 系数为0,表示归因于受试者和电路的0%差异.
- 差异最大的来源是评级者 (28.7%).
- 在受试者和类型之间的关系中也观察到显著的差异 (27%).
结论:
- 尽管进行了严格的开发,但ECMO技能评估的概括性很差.
- 缺乏对特定机构ECMO电路设计的熟悉度是限制通用性的主要因素.
- 未来的努力应集中在开发特定站点的评估工具或标准化ECMO电路设计以获得更广泛的适用性.
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