基于多学科模拟的口头降级培训改善了城市急诊科员工的知识水平和临床环境。

IF 2.2 4区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Academic Psychiatry Pub Date : 2024-09-24 DOI:10.1007/s40596-024-02051-0
Gary Duncan, Megan B Schabbing, Brad Gable
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引用次数: 0

摘要

目的:职业安全与健康管理局已建议面向患者的急诊科员工进行实操降级培训。此外,模拟学习已被证明能有效提高员工对躁动患者的了解和管理能力。本研究的目的是评估在城市急诊科的临床环境中,多学科教育课程对员工在口头降级和暴力约束使用方面的知识和信心的影响:方法:开发了一个 90 分钟的混合说教和标准化患者接触教育课程,并进行了正式汇报。学员包括来自城市急诊科的护士、病人支持助理、护理人员和保护服务人员。数据来自标准化调查。最后,还记录了因教育干预而发生的临床环境变化:共有 117/136 名急诊科工作人员(86%)完成了降级培训。据报告,培训结束后,他们对所有学习目标的信心都有所提高(同意/非常同意率大于 90%),并在 6 个月后保持了这一水平。此外,干预后暴力约束的使用率呈下降趋势。根据员工在培训中的反馈,医院制定了多项政策,包括对物理环境、到达流程和沟通方式的改变:基于多学科模拟的教育课程成功地提高了学员在管理和缓解躁动病人方面的信心。这项教育还改变了急诊科的临床环境。
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Multidisciplinary Simulation-Based Verbal De-escalation Training Improves Staff Knowledge and Clinical Environment in an Urban Emergency Department.

Objectives: Hands-on de-escalation training has been recommended for patient-facing emergency department staff by the Occupational Safety and Health Administration. Additionally, simulation-based learning has been shown to be effective at improving staff knowledge and management of agitated patients. The objective of this study was to evaluate the impact of a multidisciplinary education session on staff knowledge and confidence in verbal de-escalation and violent restraint use, in the clinical environment in an urban emergency department.

Methods: A 90-min mixed didactic and standardized patient encounter educational course with formal debriefing was developed. Learners included nurses, patient support associates, paramedics, and protective services officers from an urban emergency department. Data was obtained from standardized surveys. Lastly, changes to the clinical environment that occurred because of the educational intervention were captured.

Results: A total of 117/136 emergency department staff members (86%) completed the de-escalation training. Improved confidence (> 90% agree/strongly agree) in all learning objectives was reported immediately after training and maintained after 6 months. Additionally, the rate of violent restraint use trended down after intervention. Multiple hospital policies, including alterations to physical environment, arrival process, and communication, were enacted as a result of staff feedback during the education.

Conclusion: A multidisciplinary simulation-based educational course was successful in improving learner confidence in management and de-escalation of agitated patients. This education also led to changes in the clinical environment within the emergency department.

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来源期刊
CiteScore
3.60
自引率
20.00%
发文量
157
期刊介绍: Academic Psychiatry is the international journal of the American Association of Chairs of Departments of Psychiatry, American Association of Directors of Psychiatric Residency Training, Association for Academic Psychiatry, and Association of Directors of Medical Student Education in Psychiatry. Academic Psychiatry publishes original, scholarly work in psychiatry and the behavioral sciences that focuses on innovative education, academic leadership, and advocacy. The scope of the journal includes work that furthers knowledge and stimulates evidence-based advances in academic psychiatry in the following domains: education and training, leadership and administration, career and professional development, ethics and professionalism, and health and well-being.
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