Translation of training to practice - ultrasound guided nerve block for analgesia in patients with hip fracture.

IF 1.8 4区医学 Q2 ACOUSTICS

Medical Ultrasonography Pub Date : 2022-12-21 DOI:10.11152/mu-3537

Szemein Gan, Xiang Yin Tan, Sathya Kaliannan, Wen Jie Dennis Chia, Kim Poh Chan, Jen Heng Pek

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引用次数: 1

Abstract

Aims: Ultrasound guided nerve blocks have been shown to be an effective analgesia option for patients with hip fracture. An education program was developed to train Emergency Department doctors and it received positive feedback from partici-pants who demonstrated competency after the training. We aimed to evaluate the education program at the behavioral level of the Kirkpatrick Model by determining the translation of training to practice of ultrasound guided nerve blocks in patients with a hip fracture at the Emergency Department.

Materials and methods: A retrospective review of medical records was carried out from 18 August 2018 to 31 December 2020. Data on patient demographics, type of hip fracture, pain score, analgesia pro-vided and complications were collected using a standardized form and analyzed.

Results: Among 634 patients, their median age was 79 years old (Interquartile range (IQR): 70 to 85) and 416 (65.6%) were female. The median pain score was 6 (IQR: 5 to 8) and analgesia was provided for 561 (88.5%) patients. Analgesia was administered most frequently via the intravenous route (n=407, 72.5%) and tramadol (n=293, 52.2%) was most commonly used. Ultrasound guided nerve block was performed in 26 (4.7%) patients - all were performed successfully without complications. The utilization increased from 1.0% before to 4.7% after the conduct of the training workshops (p=0.16).

Conclusion: A significant gap still exists in the translation of training to practice. Barriers must be identified and overcome so that ultimately, the education program can bring about an organizational impact to benefit patients and improve their outcomes.

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训练到实践的转化——超声引导下神经阻滞在髋部骨折患者镇痛中的应用。

目的:超声引导神经阻滞已被证明是髋部骨折患者有效的镇痛选择。制定了一项培训急诊科医生的教育计划，并从培训后表现出能力的参与者那里得到了积极的反馈。我们的目的是通过确定在急诊科髋部骨折患者中超声引导神经阻滞的训练转化为实践来评估Kirkpatrick模型行为层面的教育项目。材料和方法:对2018年8月18日至2020年12月31日的病历进行回顾性分析。采用标准化表格收集并分析患者人口统计学数据、髋部骨折类型、疼痛评分、提供的镇痛药和并发症。结果:634例患者中位年龄79岁(四分位间距70 ~ 85)，女性416例(65.6%)。疼痛评分中位数为6 (IQR: 5 ~ 8)， 561例(88.5%)患者接受了镇痛治疗。静脉镇痛最常见(n=407, 72.5%)，曲马多最常用(n=293, 52.2%)。超声引导神经阻滞26例(4.7%)，全部成功，无并发症。培训前的使用率为1.0%，培训后的使用率为4.7% (p=0.16)。结论:从培训到实践的转化还存在着很大的差距。必须确定并克服障碍，以便最终，教育计划能够带来组织影响，使患者受益并改善他们的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical Ultrasonography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

3.20

自引率

5.90%

发文量

期刊介绍： The journal aims to promote ultrasound diagnosis by publishing papers in a variety of categories, including editorial letters, original papers, review articles, pictorial essays, technical developments, case reports, letters to the editor or occasional special reports (fundamental, clinical as well as methodological and educational papers). The papers published cover the whole spectrum of the applications of diagnostic medical ultrasonography, including basic science and therapeutic applications. The journal hosts information regarding the society''s activities, scheduling of accredited training courses in ultrasound diagnosis, as well as the agenda of national and international scientific events.