Improving PreHospital Emergency Maternal and Child Care: A Modern Approach to EMS

描述（由申请人提供）：孕妇的院前护理严重不足。虽然对儿童的院前护理进行了更好的研究，但儿科文献缺乏以人群为基础的现实世界视角的院前环境中儿童的护理。拟议的研究将缩小这些知识差距，并采取针对需求的教育战略， 紧急医疗服务（EMS）提供者及其工作环境和时间表。 拟议的项目福尔斯符合AHRQ的使命，即为重点人群创造一个更安全和更高质量的医疗保健环境。该项目的目标是在院前环境中对孕妇和儿科患者进行EMS护理。AHRQ的使命和拟议研究的目标将通过三个具体目标来实现：1。评估北卡罗来纳州儿童和孕妇紧急医疗服务（EMS）提供者的当前知识水平; 2.开发基于网络的教育内容，以解决已确定的知识差距，并部署双管齐下的教育干预措施，旨在改善儿童和孕妇在院前环境中的护理;以及3.评估研究人群中儿童和孕妇的知识和服务提供的变化。 这项研究是一项阶梯楔形随机试验设计，涉及四个农村和四个城市北卡罗来纳州县。这八个县将被随机分配到四个街区，一个是农村县，一个是城市县。这个为期五年的项目将包括五个主要组成部分，包括基于网络的继续教育学分课程、规定性学习、移动的模拟实验室、年度知识测试以及对来自全州院前数据库的患者数据的分析。EMS在知识和技能方面的不足将使用知识和模拟技能测试来衡量，结果将告知EMS收到的基于网络的课程和移动的模拟实验室中讨论的条件和主题。 本研究的长期目标是改善北卡罗来纳州EMS为孕妇和儿科患者提供的患者护理。使用这些教育方法（通过处方学习、基于网络的继续教育课程和移动的患者模拟实验室的个性化指定课程要求）、测试方法（年度知识测试和技能测试）以及数据收集和比较（知识测试结果、技能测试结果和院前患者护理数据），将评估EMS知识和技能的变化。

DESCRIPTION (provided by applicant): The prehospital care of pregnant women is severely understudied. While the prehospital care of children is better studied, the pediatric literature lacks a population-based real-world perspective of care delivered to children in the prehospital setting. The proposed research will close those gaps in knowledge and move to address identified areas of problematic delivery of care with an educational strategy tailored to the needs of Emergency Medical Services (EMS) providers and their work environment and schedules. The proposed project falls in line with AHRQ's mission to make a safer and higher quality healthcare environment for priority populations. The project will target EMS care of pregnant and pediatric patients in the prehospital environment. AHRQ's mission and the objective of the proposed study will be accomplished through three Specific Aims: 1. Assess current knowledge level of emergency medical services (EMS) providers in North Carolina for children and pregnant women; 2. Develop web-based educational content to address identified knowledge gaps and deploy a two-pronged educational intervention designed to improve the care of children and pregnant women in the prehospital environment; and 3. Evaluate changes in knowledge and service delivery for children and pregnant women within the study population. The proposed study is a stepped wedge randomized trial design involving four rural and four urban North Carolina counties. The eight counties will be randomized, one rural and one urban, to four blocks. This five-year project will include five main components, including web- based courses for Continuing Education Credits, prescriptive learning, mobile simulation labs, yearly knowledge tests, and analysis of patient data from a statewide prehospital database. EMS deficits in knowledge and skills will be measured using the knowledge and simulation skills tests and the results will inform the conditions and topics discussed in the web-based courses and mobile simulations labs received by EMS. The long-term objective of this study is to improve the patient care provided to pregnant and pediatric patients by EMS in North Carolina. Using these educational methods (individualized assigned course requirements via prescription learning, web-based continuing education courses, and mobile patient simulation labs), testing methods (yearly knowledge tests and skills tests), and data collection and comparisons (results of knowledge tests, results of skills tests, and prehospital patient care data), changes in EMS knowledge and skills will be assessed.