Implementation of a rapid response system at an isolated radiotherapy facility through simulation training.
Implementation of a rapid response system at an isolated radiotherapy facility through simulation training.
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DOI：
10.1136/bmjoq-2021-001578
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发表时间：
2022-01
期刊：
影响因子：
1.4
通讯作者：
Ohno T
中科院分区：
文献类型：
--
作者：
Kawamura H;Komatsu Y;Tanaka K;Kanamoto M;Tobe M;Usami C;Hinohara H;Oshima K;Kitada Y;Tsuda K;Ogano T;Shimada H;Ohno T
当由于地理位置而难以进入急诊室并且患者被固定装置固定时，在放射治疗部门中需要快速响应系统用于经历危急事件的患者。因此，我们重建了响应系统，并通过现场模拟对其进行了测试。创建了一个多学科核心小组，并采用“计划-实施-研究-行动”循环进行了现场模拟。我们确定了我们设施的重要特征，包括它与急诊室的距离;许多工作人员与患者的直接接触很少;治疗室环境和患者对放射治疗设备的固定。我们还检查了应急响应的每个阶段的流程：检测紧急情况，呼叫医疗应急小组（MET），将MET运送到现场，现场响应和将患者运送到急诊室。修改了方案，并更新了设备。在事先解释和不解释方案和培训方案的情况下进行了现场模拟。在本项目之前的2017年模拟期间，MET到达现场的时间为7分钟，而在第一次模拟会议之后到达的时间缩短为5分钟，然后在第二次会议中进一步缩短为4分钟，尽管没有事先解释情况。在一个孤立的辐射设施进行了一个现场模拟的多学科应急项目。精心策划的应急响应不仅在重离子治疗设施中很重要，而且在其他部门和设施中也很重要，这些部门和设施不容易进入医院急诊室。
A rapid response system is required in a radiotherapy department for patients experiencing a critical event when access to an emergency department is poor due to geographic location and the patient is immobilised with a fixation device. We, therefore, rebuilt the response system and tested it through onsite simulations. A multidisciplinary core group was created and onsite simulations were conducted using a Plan-Do-Study-Act cycle. We identified the important characteristics of our facility, including its distance from the emergency department; the presence of many staff with little direct contact with patients; the treatment room environment and patient fixation with radiotherapy equipment. We also examined processes in each phase of the emergency response: detecting an emergency, calling the medical emergency team (MET), MET transportation to the site and on-site response and patient transportation to the emergency department. The protocol was modified, and equipment was updated. On-site simulations were held with and without explanation of the protocol and training scenario in advance. The time for the MET to arrive at the site during a 2017 simulation prior to the present project was 7 min, whereas the time to arrive after the first simulation session was shortened to 5 min and was then shortened further to 4 min in the second session, despite no prior explanation of the situation. A multidisciplinary project for emergency response with on-site simulations was conducted at an isolated radiation facility. A carefully planned emergency response is important not only in heavy ion therapy facilities but also in other departments and facilities that do not have easy access to hospital emergency departments.