Evaluating Shifts in Perception After a Pilot Trauma Quality Improvement Training Course in Cameroon.
Evaluating Shifts in Perception After a Pilot Trauma Quality Improvement Training Course in Cameroon.
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评估喀麦隆飞行员创伤质量改进培训课程后认知的转变。
DOI：
10.1016/j.jss.2022.02.019
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发表时间：
2022
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作者：
Nguyen,NicoleT;Ding,Kevin;Oke,Rasheedat;Tanjong,Mary-MagdaleneS;Mbuh,Lidwine;Mbianyor,MbiarikaiA;Carvalho,Melissa;DissakDelon,FannyNadia;Boeck,Marissa;Collins,Caitlin;Yenshu,EmmanuelV;Etoundi,GeorgeAlain;Juillard,Catherine;
创伤是造成全球疾病负担的一个主要因素，低收入和中等收入国家（LMICs）受到的影响尤为严重。创伤质量改善（QI）倡议每年可能挽救约200万人的生命。成功的创伤精神质量倡议依赖于医院工作人员的充分培训和质量文化。本研究评估了喀麦隆试点创伤QI培训课程对参与者对领导力、医疗差错和QI过程的看法的影响。方法研究参与者参加了为期三天，八个模块的创伤气方法和应用课程培训。对领导力、医疗失误和QI的认知在课程前后使用李克特五分制的15项调查进行评估。使用Wilcoxon符号秩检验比较课程前和课程后的中位数分数。在课程结束后的调查和评估中，对知识保留和课程满意度进行了评估。结果25名课程参与者中，92%完成了课程前和课程后的问卷调查。课程结束后，参与者对工作中医疗差错讨论的安全感和舒适感显著增加（前中位数= 5,IQR[4-5]；后中位数= 5,IQR [5-5]；P= 0.046）。课程结束后，认为应对医疗错误负责的个人应被追究责任的人数显著减少（前中位数= 3,IQR[2-4]；后中位数= 1,IQR [1-2]；P< 0.001）。总体满意度较高，中位评分≥4分。结论这些初步结果表明，有针对性的创伤气训练可以有效地影响对气的态度。进一步调查创伤性精神质量培训对医院工作人员的影响，以评估这些发现的可重复性是有必要的。
IntroductionTrauma is a major contributor to the global burden of disease, with low- and middle-income countries (LMICs) being disproportionately affected. Trauma Quality Improvement (QI) initiatives could potentially save an estimated two million lives each year. Successful trauma QI initiatives rely on adequate training and a culture of quality among hospital staff. This study evaluated the effect of a pilot trauma QI training course on participants’ perceptions on leadership, medical errors, and the QI process in Cameroon.MethodsStudy participants took part in a three-day, eight-module course training on trauma QI methods and applications. Perceptions on leadership, medical errors, and QI were assessed pre and post-course using a 15-item survey measured on a five-point Likert scale. Median pre- and post-course scores were compared using the Wilcoxon signed-rank test. Knowledge retention and course satisfaction were also evaluated in a post-course survey and evaluation.ResultsA majority of the 25 course participants completed pre-course (92%) and post-course (80%) surveys. Participants’ perceptions of safety and comfort discussing medical errors at work significantly increased post-course (pre-median = 5, IQR [4-5]; post-median = 5, IQR [5-5];P= 0.046). The belief that individuals responsible for medical error should be held accountable significantly decreased after the course (pre-median = 3, IQR [2-4]; post-median = 1, IQR [1-2];P< 0.001). Overall satisfaction with the course was high with median scores ≥4.ConclusionsThese initial results suggest that targeted trauma QI training effectively influences attitudes about QI. Further investigation of the effect of the trauma QI training on hospital staff in larger courses is warranted to assess reproducibility of these findings.