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Massive Hemorrhage Protocol Application and Teamwork Skills

机译:大量出血方案应用和团队合作技能

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Objective Massive hemorrhages (MHs) are rare but serious complications of pediatric trauma and obstetric cases. This study aimed to evaluate the impact of interprofessional simulation to improve adherence to a MH protocol (MHP), teamwork skills and confidence levels during a hemorrhagic crisis situation. This was a pre-post experimental study conducted at a tertiary care mother-child simulation center. Pediatric emergency and obstetric teams were submitted to simulated trauma and postpartum MH scenarios. Training consisted of two case scenarios followed by debriefing sessions and a lecture on the MHP. The primary outcome was adherence to MHP processes (checklist) measured prior to and 2 weeks following training sessions. Other outcomes were the measure of teamwork skills (Mayo High Performance Teamwork Scale) and confidence of the participants. Methods Results Sixty-two health care professionals were involved in eight interprofessional teams. Mean scores for adherence to the MHP improved from 19.1 in the pretraining phase to 25.8 in the posttraining phase (difference of 6.7; 95 confidence interval CI = 4.4 to 8.9). Mean scores pertaining to teamwork skills also improved significantly between pre- and posttraining phases (difference = 3.9; 95 CI = 1.5 to 6.4). Confidence questionnaires showed significant improvements in the posttraining phase (difference = 6.9; 95 CI = 5.3 to 8.3). Conclusions Targeted training involving simulation and protocol review improved participant adherence to MHP processes and teamwork skills. Confidence levels improved across all disciplines.
机译:目的 大出血(MHs)是小儿创伤和产科病例罕见但严重的并发症。本研究旨在评估跨专业模拟在出血性危机情况下提高对 MH 协议 (MHP) 的依从性、团队合作技能和信心水平的影响。这是一项在三级护理母子模拟中心进行的前后实验研究。儿科急诊和产科团队被提交到模拟创伤和产后 MH 场景。培训包括两个案例场景,然后是汇报会议和关于 MHP 的讲座。主要结局是在培训课程之前和之后 2 周测量的对 MHP 流程(清单)的依从性。其他结局是团队合作技能的测量(梅奥高性能团队合作量表)和参与者的信心。方法 结果 62名医护人员参与8个跨专业团队。遵守 MHP 的平均得分从训练前阶段的 19.1 分提高到训练后阶段的 25.8 分(差异 6.7;95% 置信区间 [CI] = 4.4 至 8.9)。在训练前和训练后阶段之间,与团队合作技能相关的平均得分也显著提高(差异=3.9;95%CI=1.5至6.4)。置信度问卷显示训练后阶段有显著改善(差异=6.9;95%CI=5.3至8.3)。结论:有针对性的培训涉及模拟和协议审查,提高了参与者对 MHP 流程的依从性和团队合作技能。所有学科的置信水平都有所提高。

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