Neonatal Healthcare Professionals' Experiences When Implementing a Simulation and Debriefing Program in Neonatal Intensive Care Settings: A Qualitative Analysis.
Neonatal Healthcare Professionals' Experiences When Implementing a Simulation and Debriefing Program in Neonatal Intensive Care Settings: A Qualitative Analysis.
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新生儿保健专业人员在新生儿重症监护环境中实施模拟和汇报计划时的经验：定性分析。
DOI：
10.1097/anc.0000000000001085
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Lee,HenryC
中科院分区：
文献类型：
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作者：
Quinn,Jenny;Quinn,Megan;Lieu,Brandon;Bohnert,Janine;Halamek,LouisP;Profit,Jochen;Fuerch,JaneneH;Chitkara,Ritu;Yamada,NicoleK;Gould,Jeff;Lee,HenryC
背景：模拟为基础的培训（SBT）和述职增加了医疗保健作为一种方法进行跨专业的团队training in a realistic environment.Purpose：本定性研究的目的是描述新生儿医疗保健专业人员的经验时，实施病人的安全模拟和述职程序在新生儿重症监护室（NICU）。方法：十四NICU在加州和俄勒冈州参加了为期15个月的质量改进协作与加州围产期质量护理协作。参与研究中心完成了3个月的实施前工作，随后是12个月的模拟和汇报计划的积极实施。在合作期间，对每个研究中心进行了2次焦点小组访谈。内容分析发现新兴的实施主题。结果：有234名参与者在2个焦点小组访谈。提出了六个执行主题：（1）接受环境;（2）领导支持;（3）文化变革;（4）模拟情景;（5）汇报方法;（6）可持续性。主要的障碍和促进者与实施SBT围绕有一个接受的背景下，在单位层面（如，可用的资源和时间）和多学科的领导support.Implications的实践和研究：NICU有不同的环境（上下文）因素和考虑单位层面的上下文因素和支持，从领导是不可或缺的方面，提高成功实施的模拟和述职程序新生儿复苏。需要对克服领导者和参与者障碍的实施方法以及确定临床医生SBT的最佳频率进行更多研究。关于SBT患者结局的改善，仍然存在知识差距。
Background:Simulation-based training (SBT) and debriefing have increased in healthcare as a method to conduct interprofessional team training in a realistic environment.Purpose:This qualitative study aimed to describe the experiences of neonatal healthcare professionals when implementing a patient safety simulation and debriefing program in a neonatal intensive care unit (NICU).Methods:Fourteen NICUs in California and Oregon participated in a 15-month quality improvement collaborative with the California Perinatal Quality Care Collaborative. Participating sites completed 3 months of preimplementation work, followed by 12 months of active implementation of the simulation and debriefing program. Focus group interviews were conducted with each site 2 times during the collaborative. Content analysis found emerging implementation themes.Results:There were 234 participants in the 2 focus group interviews. Six implementation themes emerged:(1) receptive context;(2) leadership support;(3) culture change;(4) simulation scenarios;(5) debriefing methodology; and (6) sustainability. Primary barriers and facilitators with implementation of SBT centered around having a receptive context at the unit level (eg, availability of resources and time) and multidisciplinary leadership support.Implications for Practice and Research:NICUs have varying environmental (context) factors and consideration of unit-level context factors and support from leadership are integral aspects of enhancing the successful implementation of a simulation and debriefing program for neonatal resuscitation. Additional research regarding implementation methods for overcoming barriers for both leaders and participants, as well as determining the optimal frequency of SBT for clinicians, is needed. A knowledge gap remains regarding improvements in patient outcomes with SBT.