使用模拟教育(SBE)来提高患者从急性到临终关怀过渡的认识和管理

Jane Brundish, Genevieve Russell
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引用次数: 0

摘要

在任何情况下,识别和管理病情恶化的患者对卫生保健提供者(HCPs)来说都是一件具有挑战性和痛苦的事情。临终关怀是护理和医学教育的核心组成部分,但历史上却很少受到关注。基于模拟的教育(SBE)已被证明是一种有效的工具,可以在涉及复杂的临床场景和倡导以患者为中心的护理时提高医护人员的能力和信心[1]。国家对及时、个性化的临终关怀的认识和提供正在推动对多学科团队教育的需求[2][3]。设计、实施和修改SBE计划,以提高病人病情恶化时的护理质量。SBE将被用来实现这一目标,通过提高一个有凝聚力的多学科团队在护理病情恶化的病人时的信心和能力。每年举办三个SBE学习日,通过在线门户网站预订。会议由重症监护、姑息医学和实践发展团队的医护人员提供便利。一份概述SBE情景和学习目标的手册会提前分发,这份预简介可以让学习者准备和理解当天的形式。教学日由三个临床场景组成,跟随患者经历他们疾病的不同阶段:最初是急性评估和升级,导致考虑个人治疗升级计划,最终是他们的临终关怀。通过基于证据的角色扮演,通过模拟学习是多方面的,观察者作为学习者,在每个场景之后通过促进反馈进行集体汇报。所有学习者提供的在线反馈在整个四年的课程开发过程中得到整理。评价揭示了三个主要主题;学习者看重SBE,因为它可以复制实践,简报讨论巩固了学习,并使学习者有机会了解它将如何改善他们的实践,并且重视多学科团队学习。SBE是一种有效的方法,可以在任何情况下提高HCPs对病情恶化患者的个性化和协调护理的质量。作为一种有效的工具,它也与国家的努力保持一致,即通过积极主动的预先护理计划讨论和对临终者及其家属的整体护理,提高对临终患者的认识。作者确认已符合研究行为和传播的所有相关伦理标准。提交作者确认已获得相关的伦理批准(如适用)。
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A63 The use of simulation based education (SBE) to improve recognition and management of patients in the transition from acute to end of life care
Recognizing and managing a deteriorating patient, in any setting, can be a challenging and distressing event for health care providers (HCPs). End of life care is a core component of nursing and medical education, yet historically has received minimal focus. Simulation Based Education (SBE) has been shown to be an effective tool for enhancing HCPs competence and confidence when involved with complex clinical scenarios and advocating patient-centred care [1]. The national drive to increase recognition and provision of timely, individualized end of life care is catalysing the need for multidisciplinary team education [2] [3]. To design, deliver and modify SBE programme to enhance quality of patient care as they deteriorate. SBE will be utilized to achieve this by increasing both confidence and competence of a cohesive multidisciplinary team when involved in the care of deteriorating patients. Three SBE study days are held each year which are booked through an online portal. The sessions are facilitated by HCPs from intensive care, palliative medicine, and the practice development team. A handbook outlining SBE scenarios and learning objectives is distributed in advance, this pre-brief allows learners to prepare and understand the format of the day. The teaching day is structured with three clinical scenarios following a patient through different stages of their illness: initially an acute assessment and escalation, leading to consideration of individual treatment escalation plans and ultimately their end-of-life care. Learning through simulation is multifaceted through evidence-based role play, with observers as learners and collective debriefing through facilitated feedback after every scenario. Online feedback provided by all learners has been collated throughout the four-year course development process. Evaluations revealed three main themes; learners valued SBE in terms of replicating practice, de-briefing discussions consolidated learning and enabled learners the opportunity to understand how it will improve their practice and value was placed on multidisciplinary team learning. SBE is an effective method of enhancing the quality of individualized and coordinated care delivered to a deteriorating patient in any setting by HCPs. As an effective tool it also stands aligned with the national drive to improve recognition of patients at the end of their life with proactive advance care planning discussions and holistic care for the dying and their families. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.
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