Simulation Training to Increase Holding of Fragile Infants in Cardiac Intensive Care Units.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE American Journal of Critical Care Pub Date : 2024-09-01 DOI:10.4037/ajcc2024658

Christine Rachwal, Melissa Smith-Parrish, Valerie Rofeberg, Kelsey Graber, Duncan Smith-Freedman, Marlena Smith Millman, Meagan Garafalo, Sonia Almeida-Santos, Michelle Panaccione, Angela Sorensen, Suzanne Stuzynski, Karen Horn, Gina Ubertini, Shana Peruti, Samantha C Butler

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Abstract

Background: Promoting bonding and neurodevelopmental care is an important element in the cardiovascular intensive care unit (CICU); however, holding of infants by family members is inconsistently practiced.

Objectives: This quality improvement study aimed to safely increase the holding of medically complex infants in the CICU by developing a holding guideline and offering simulation-based staff education.

Methods: Using consensus methodology and high-fidelity simulation, an expert work group created a holding guideline and training to increase staff confidence and competence in holding critically ill infants in the CICU. The effectiveness of the intervention was tested via a postintervention survey used to assess participants' confidence in and comfort with holding critically ill infants and elicit suggestions for further support. Participants who engaged with the mannequin were surveyed to assess the validity of the simulation trainer.

Results: After the intervention, participants (N = 130) reported increased confidence with infant holding (76%) and greater confidence in preparing families to hold their infants. Participants (95%) strongly agreed that the simulation enabled realistic, safe practice in holding a medically complex infant with catheters and tubes. More years of experience and engagement with the simulation trainer were associated with increased posttraining confidence. Participants cited increased resources, practice, and adherence monitoring as key supports for infant holding.

Conclusions: Expert group consensus with high-fidelity simulation training is a feasible, safe, and reliable method for teaching higher risk skills and guiding protocol development.

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通过模拟训练加强心脏重症监护室对体弱婴儿的护理。

背景：促进亲子关系和神经发育护理是心血管重症监护病房（CICU）的一项重要内容；然而，由家庭成员抱着婴儿的做法并不一致：这项质量改进研究旨在通过制定抱婴指南和提供基于模拟的员工教育，安全地提高 CICU 中病情复杂婴儿的抱婴率：方法：专家工作小组利用共识方法和高仿真模拟，制定了抱姿指南并开展培训，以增强重症监护室员工抱姿的信心和能力。干预措施的有效性通过干预后调查进行检验，调查用于评估参与者对抱住危重症婴儿的信心和舒适度，并征求进一步支持的建议。此外，还对使用人体模型的参与者进行了调查，以评估模拟培训师的有效性：干预结束后，参与者（N = 130）表示对抱起婴儿的信心有所增强（76%），并对让家人做好抱起婴儿的准备更有信心。参与者（95%）非常同意模拟训练能够让他们在抱着患有复杂内科疾病并带有导管和插管的婴儿时进行真实、安全的练习。与模拟培训师合作的年限越长、经验越丰富，培训后的信心就越强。参与者认为，增加资源、实践和坚持监测是婴儿抱持的关键支持：专家组一致认为，高仿真模拟训练是教授高风险技能和指导方案制定的一种可行、安全、可靠的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Critical Care 医学-护理

CiteScore

4.30

自引率

3.70%

发文量

103

审稿时长

6-12 weeks

期刊介绍： The editors of the American Journal of Critical Care (AJCC) invite authors to submit original manuscripts describing investigations, advances, or observations from all specialties related to the care of critically and acutely ill patients. Papers promoting collaborative practice and research are encouraged. Manuscripts will be considered on the understanding that they have not been published elsewhere and have been submitted solely to AJCC.

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