In Situ Simulation Training for Neonatal Resuscitation: An RCT
In Situ Simulation Training for Neonatal Resuscitation: An RCT
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DOI：
10.1542/peds.2013-3988
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发表时间：
2014-09-01
期刊：
影响因子：
8
通讯作者：
Picaud, Jean-Charles
中科院分区：
文献类型：
--
作者：
Rubio-Gurung, Sophie;Putet, Guy;Picaud, Jean-Charles
目的：高保真模拟是向专业人员传授新生儿复苏技能的有效工具。我们的目标是确定现场模拟培训(类似于80%的产房工作人员)是否改善了产妇工作人员进行的新生儿复苏。方法：对12名产妇进行基线评估：每个单位随机抽取10名专业人员，在新生儿高保真模拟器上播放2个标准化场景。医疗过程被录像下来，以供以后评估。然后，12名产妇被随机分配接受干预(为6名专业人员组成的多学科小组现场提供4小时模拟培训课程)或不接受干预。干预后3个月再次对所有产妇进行评估。视频由2名新生儿医生对干预前/干预后和干预/对照组进行盲法评估。结果：干预后，干预组在情景1和情景2中的技术得分显著高于对照组(P分别为.01和0.004)，两种情景的团队得分中位数显著高于对照组(P<；.001)。干预组在3分钟达到90次/分钟心率的频率显著提高(P=.003)，危险事件发生次数明显减少(P<；.001)。结论：多学科团队现场模拟训练能有效提高新生儿复苏的技能和团队合作能力。
OBJECTIVES: High-fidelity simulation is an effective tool in teaching neonatal resuscitation skills to professionals. We aimed to determine whether in situ simulation training (for similar to 80% of the delivery room staff) improved neonatal resuscitation performed by the staff at maternities.METHODS: A baseline evaluation of 12 maternities was performed: a random sample of 10 professionals in each unit was presented with 2 standardized scenarios played on a neonatal high-fidelity simulator. The medical procedures were video recorded for later assessments. The 12 maternities were then randomly assigned to receive the intervention (a 4-hour simulation training session delivered in situ for multidisciplinary groups of 6 professionals) or not receive it. All maternities were evaluated again at 3 months after the intervention. The videos were assessed by 2 neonatologists blinded to the pre-/postintervention as well as to the intervention/control groups. The performance was assessed using a technical score and a team score.RESULTS: After intervention, the median technical score was significantly higher for scenarios 1 and 2 for the intervention group compared with the control group (P = .01 and 0.004, respectively), the median team score was significantly higher (P < .001) for both scenarios. In the intervention group, the frequency of achieving a heart rate >90 per minute at 3 minutes improved significantly (P = .003), and the number of hazardous events decreased significantly (P < .001).CONCLUSIONS: In situ simulation training with multidisciplinary teams can effectively improve technical skills and teamwork in neonatal resuscitation.