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通过现场模拟增加护士带领的重症儿童动员:质量改进倡议
Jessica M LaRosa1, Hallie Lenker2, Colleen Mennie1
1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
概括
儿科重症监护室 (PICU) 护士的现场早期移动模拟显著增加了护士领导的患者动员. 这项质量改进计划提高了护士的信心和知识,而不会影响患者的安全.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 质量改善举措 质量改善举措
- 护理教育和模拟护理教育
背景情况:
- 危急病患的儿童面临着无法移动的可预防的疾病.
- 早期流动性对于改善儿科重症监护室 (PICU) 的治疗结果和降低死亡率至关重要.
- 早期流动性协议的遵守率较低,凸显了改善护理干预措施的需要.
研究的目的:
- 评估现场早期流动性模拟对PICU护士的影响.
- 确定模拟是否增加了护士领导的重症儿童动员.
- 评估有关早期流动性的护理知识和自我效能的变化.
主要方法:
- 一个使用观察性,前后设计的质量改进倡议.
- 在高等学术医院的PICU中进行,涉及重症儿科患者.
- 为PICU护士实施了一个现场模拟会.
主要成果:
- 干预后,护士领导的调动人数中位数每名患者每次12小时班次从5增加到6 (p=0.02).
- 模拟参与与动员的显著增加相关 (1.9每位患者每班,p=0.004).
- 在调动患者方面,护理知识 (p=0.004) 和自我有效性 (p<0.001) 显著改善,但安全事件没有增加.
结论:
- 在现场早期移动模拟有效地增加了重症儿童的护士领导的动员.
- 模拟提高了护士的信心和知识,而不会影响患者的安全.
- 需要进一步的研究来探索长期影响和通用性.
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