a60a基于模拟的质量改进项目,以改善紧急护理环境中的患者护理

Claire Cree, Marta Soares-Preece
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引用次数: 0

摘要

在项目开始前的两年里,数据显示,在一个紧急护理病房,与患者安全有关的事件很高。也有证据表明,工作人员流动率和在职初级工作人员的人数也比平时高,而得到的支助很少。为期八个多月的一系列月度临床模拟教育(SBE)课程旨在让员工在安全的空间中练习在该环境中工作所需的特定临床技能,最终通过增加知识、技能和信心来实现更安全的患者护理,[1]。培训包括每月3个小时的课程,每个课程有3个场景,每个场景都有一个结构化的汇报,以巩固理解和学习。场景与紧急护理相关,并使用高保真模拟器尽可能真实。采用混合方法收集11个月的定性和定量数据,以便进行稳健分析,[2]。会议前和会议后,候选人完成了信心量表,并填写了一份反馈表格,以确定关键的学习点,并就其适用性提出建议。进行了一项比较研究,收集了项目开始和结束时的患者安全数据。26名候选人参加了面试。3人出席两次。候选人是具有不同程度紧急护理经验的合格和学生护士和卫生保健助理。在接下来的几次会议中,所有的候选人都报告说,他们对治疗病情恶化的病人更有信心了,他们对寻求帮助也更有信心了。他们都说场景与实践相关。在7个共同主题中确定了65个学习点。会议最有用的部分是现实主义和相关性。患者安全数据显示,报告的事故数量有所改善。一些变量可能会影响数据,需要进一步研究。结果是积极的,该项目已被整个信托基金会的紧急护理部门采用,以改善患者安全和留住员工。该项目旨在通过向一个紧急护理病房的员工提供SBE来改善患者安全。数据分析表明,这对病人护理有一些好处,并对员工信心产生了积极影响。它还确定了关键的学习主题。该教育项目将在整个信托基金范围内开展,进一步的研究将获得更有说服力的数据。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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A60 A Simulation Based Quality Improvement Project to improve patient care in the Urgent Care Environment
In the two years prior to commencement of the project, data suggested that incidents related to patient safety were high on one Urgent Care Ward. Evidence also suggested that staff turnover and the number of junior staff in post were also higher than usual with little support available. A series of monthly, clinical Simulation Based Education, (SBE) Sessions were held over eight months with the aim of allowing staff to practice, in a safe space, the specific clinical skills required to work in that environment ultimately resulting in safer patient care by increasing knowledge, skills and confidence, [1]. Training consisted of monthly 3-hour sessions, 3 scenarios per session, each followed by a structured debriefing cementing understanding and learning. Scenarios were relevant to Urgent Care and as realistic as possible using High Fidelity Simulators. A mixed methodology was used to collect qualitive and quantitative data over 11 months allowing for robust analysis, [2]. Pre and Post session Confidence Scales were completed by candidates as well as a feedback form to identify key learning points and to advise on the suitability. A comparison study was made, collecting patient safety data at the beginning and end of the project. 26 candidates attended. 3 attended twice. Candidates were qualified and student Nurses and Health Care Assistants with varying levels of Urgent Care experience. Following sessions all candidates reported that they felt more confident managing deteriorating patients and that they felt more confident to summon assistance. They all reported that scenarios were relevant to practice. 65 learning points were identified with 7 common themes. The most useful part of sessions was realism and relevance. Patient Safety Data indicates some improvement in the number of reported incidents. Some variables could have influenced data and further study is required. Results were positive and the project has been adopted throughout Urgent Care across the Trust to improve patient safety and retain staff The project aimed to improve patient safety by providing SBE to staff on one Urgent Care Ward. Analysis of data suggests there was some benefit to patient care and demonstrated a positive impact on staff confidence. It also identified key learning themes. The educational program will be offered across the Trust and further study will enable more persuasive data. 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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