A74使用模拟技术来支持提供紧急社区响应服务(UCR)的跨专业团队提高技能

Belinda Twissell, Kate Olsen, Deryn Creasy
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引用次数: 0

摘要

NHS提供者没有为基于社区的联合卫生专业人员(AHP)建立模拟教育机会。紧急社区响应(UCR)团队是由护士、护理人员、物理治疗师和职业治疗师组成的跨学科团队,他们在家中为成年人提供护理,以避免住院[1]。当一个多技能的临床医生跨越通常的专业界限工作时,老年人可以有效地解决他们的需求,而不是要求许多其他专业人员上门就诊,他们就可以获得有效的高质量护理。在这个NHS信托中,中级护理团队被要求将UCR转诊作为他们日常工作的一部分。来自这些团队的物理治疗师和职业治疗师需要提高技能,以便能够安全地支持需要这种更急性和紧急护理水平的患者。在社区工作的临床医生相互观察和学习的机会有限。模拟是一种基于证据的教育活动,支持临床环境中跨学科团队工作所需的新知识和技能的发展[2]。假设跨专业模拟将是一种有效的教育干预,以支持这种技能的提高。成立了一个教师队伍,其中包括一名模拟教师;仿真技术;实践发展层次分析法;还有一名有临床工作经验的理疗师。开发了模拟情景以反映常见的转诊情况;《卫生技能UCR能力框架》[3];学习成果被临床医生和服务经理确定为优先事项。学习成果包括采用A到E评估;在家中评估成年患者时,NEWS2和SBAR升级工具的使用。采用改进的Kirkpatrick评估表对训练进行评估。提供了三次模拟培训活动。共有26名参与者,分别来自物理治疗、职业治疗、护理和保健支持工作者。修改后的Kirkpatrick评估表有14个评价反应。评估发现,模拟提供了向其他专业学习的机会;支持学习的实际应用;汇报提供了一个安全的学习环境;并且学习将导致他们当前实践的变化(参见评估主题与支持示例)模拟培训事件由来自跨专业社区团队的参与者评估,作为一种安全,实用和有效的方式来支持他们提高提供UCR服务的技能。应将模拟视为一揽子教育的一部分,以支持跨专业团队提高技能,以便在社区环境中提供新服务。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)。这项工作是由NHS英格兰(东南)劳动力、培训和教育资助的奖学金项目的一部分;与弗洛伦斯南丁格尔基金会和坎特伯雷基督教堂大学合作。
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A74 The use of simulation to support the upskilling of interprofessional teams providing an Urgent Community Response service (UCR)
An NHS provider had no established simulation education opportunities for community based allied health professionals (AHP). Urgent Community Response (UCR) teams are interdisciplinary teams, comprised of nurses, paramedics, physiotherapists and occupational therapists, who provide care to adults in their home to avoid hospital admission [1]. Older people experience effective high-quality care when a multi-skilled clinician, working across the usual professional boundaries, can effectively address their needs rather than requiring numerous other professionals to visit them at home. In this NHS Trust, intermediate care teams were required to include UCR referrals as part of their usual work. The physiotherapists and occupational therapists from these teams required upskilling to be able to safely support patients requiring this more acute and urgent level of care. Clinicians working in the community have limited opportunity to observe and learn from each other. Simulation is an evidenced based educational activity to support the development of new knowledge and skills required in interdisciplinary teams working in clinical settings [2]. It was hypothesized that interprofessional simulation would be an effective educational intervention to support this upskilling. A faculty was established which included a simulation educator; simulation technician; a practice development AHP; and a physiotherapist with clinical experience of working within this setting. Simulation scenarios were developed to reflect common referral presentations; the Skills for Health UCR Capability Framework [3]; and learning outcomes identified as priorities by the clinicians and service managers. The learning outcomes included applying an A to E assessment; the use of NEWS2 and the SBAR escalation tool when assessing an adult patient in their own home. A modified Kirkpatrick evaluation form was used to evaluate the training. Three simulation training events were offered. There were 26 participants overall with representation from physiotherapy, occupational therapy, nursing and healthcare support workers. There were fourteen evaluation responses to a modified Kirkpatrick evaluation form. The evaluation identified that simulation provided an opportunity to learn from other professions; supported the practical application of learning; debriefing provided a safe learning environment; and that the learning would lead to changes in their current practice (see Evaluation themes with supporting examples Simulation training events were evaluated by participants from an interprofessional community team as a safe, practical and effective way to support their upskilling to provide an UCR service. Simulation should be considered as part of an education package to support interprofessional teams upskilling to provide new services in a community setting. 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. This work forms part of a fellowship project funded by NHS England (South East) Workforce, Training and Education; with the Florence Nightingale Foundation and Canterbury Christ Church University.
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