Improving patient safety with just-in-time pediatric simulation training

通过及时的儿科模拟培训提高患者安全

• 批准号: 7289256
• 负责人: VINAY M NADKARNI
• 金额: $ 27.69万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7289256
• 关键词: Improving; patient; safety; just; time

DESCRIPTION (PROVIDED BY THE APPLICANT): Advanced pediatric airway management is critical for optimized treatment of children. Our long-term goal is to improve patient safety during advanced pediatric airway management. Safe tracheal intubation procedures require sophisticated individual and multidisciplinary team skills that are taught and learned in the pediatric intensive care unit (PICU). Strong preliminary data using the National Emergency Airway Registry (NEAR) specifically adapted for children by our research team demonstrates that intubation success and adverse events are associated with supervised physician trainees who rarely perform this procedure, and their performance is not as safe as identically supervised but experienced sharp end providers. The objective of this proposal is to evaluate the effect of "just-in-time" simulation overtraining on safety and efficacy of advanced airway management. Our Center for Simulation, Advanced Education and Innovation has developed simulation tools that enhance self-efficacy, competence, and team communication. This prospective, interventional study will randomize sharp end providers assigned to manage airway emergencies in the pediatric ICU to either no overtraining versus 20 minutes of either low fidelity or high fidelity simulation overtraining with two specific aims: 1) To evaluate the efficacy of "just-in-time" simulation overtraining; and 2) To evaluate the impact of high versus low fidelity simulation on patient safety outcomes. Both simulated and actual patient tracheal intubations will be evaluated using the NEAR tool, and the primary outcome of tracheal intubation success on first attempt and secondary outcomes of tracheal intubation associated events will be rigorously analyzed by techniques developed and validated by our research team. Relevance to the agency mission: If simulation overtraining of sharp end providers improves actual patient safety, our hospital organization will rapidly implement and track the safety impact of these education tools in practice. Providers, health educators, payers, policy makers, patients, the public and AHRQ would be informed on how to improve the delivery of safe health care across diverse healthcare settings. Safe advanced pediatric airway management requires experienced and trained providers. If this study demonstrates that simulation overtraining improves safety, these techniques will be adopted and implemented in diverse high-risk settings to improve the care of critically ill children.

描述（由申请人提供）：先进的儿科气道管理对于优化儿童治疗至关重要。我们的长期目标是在高级儿科气道管理过程中提高患者安全。安全的气管插管手术需要在儿科重症监护病房 (PICU) 中教授和学习的复杂的个人和多学科团队技能。我们的研究团队使用专门针对儿童的国家紧急气道登记处 (NEAR) 提供的强有力的初步数据表明，插管成功和不良事件与很少执行此操作的受监督医师实习生有关，而且他们的表现不如受同样监督但经验丰富的尖端提供者安全。该提案的目的是评估“即时”模拟过度训练对高级气道管理的安全性和有效性的影响。我们的模拟、高级教育和创新中心开发了能够提高自我效能、能力和团队沟通的模拟工具。这项前瞻性、介入性研究将随机分配被指派处理儿科 ICU 气道紧急情况的尖端医疗服务提供者，要么不进行过度训练，要么进行 20 分钟的低保真度或高保真度模拟过度训练，有两个具体目的： 1) 评估“及时”模拟过度训练的效果； 2) 评估高保真度模拟与低保真度模拟对患者安全结果的影响。将使用 NEAR 工具评估模拟和实际患者气管插管，并且将通过我们的研究团队开发和验证的技术严格分析首次尝试气管插管成功的主要结果和气管插管相关事件的次要结果。与机构使命的相关性：如果尖端提供者的模拟过度培训改善了患者的实际安全，我们的医院组织将在实践中快速实施和跟踪这些教育工具的安全影响。提供者、健康教育者、付款人、政策制定者、患者、公众和 AHRQ 将了解如何在不同的医疗保健环境中改善安全医疗保健的提供。安全的高级儿科气道管理需要经验丰富且训练有素的提供者。如果这项研究证明模拟过度训练可以提高安全性，那么这些技术将在不同的高风险环境中被采用和实施，以改善危重儿童的护理。