Enhancing trauma care through innovative trauma and disaster team response training: A blended learning approach in Tanzania.

Cherinet Osebo, T. Razek, D. Deckelbaum, J. Grushka, K. Khwaja, Ali Fazlollahi, Christian Vlček, Eadan Farber, Johana Montero Ortiz, Alexa Papanastasiou, Rabi Ndeserua, Bryson Mcharo, Anna Lemnge, Albert Ulimali, L. Rwanyuma, V. Munthali, R. Boniface
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Abstract

BACKGROUND In Tanzania, inadequate infrastructures and shortages of trauma-response training exacerbate trauma-related fatalities. McGill University's Centre for Global Surgery introduced the Trauma and Disaster Team Response course (TDTR) to address these challenges. This study assesses the impact of simulation-based TDTR training on care providers' knowledge/skills and healthcare processes to enhance patient outcomes. METHODS The study used a pre-post-interventional design. TDTR, led by Tanzanian instructors at Muhimbili Orthopedic Institute from August 16-18, 2023, involved 22 participants in blended online and in-person approaches with simulated skills sessions. Validated tools assessed participants' knowledge/skills and teamwork pre/post-interventions, alongside feedback surveys. Outcome measures included evaluating 24-h emergency department patient arrival-to-care time pre-/post-TDTR interventions, analyzed using parametric and non-parametric tests based on data distributions. RESULTS Participants' self-assessment skills significantly improved (median increase from 34 to 58, p < 0.001), along with teamwork (median increase from 44.5 to 87.5, p < 0.003). While 99% of participants expressed satisfaction with TDTR meeting their expectations, 97% were interested in teaching future sessions. The six-month post-intervention arrival-to-care time significantly decreased from 29 to 13 min, indicating a 55.17% improvement (p < 0.004). The intervention led to fewer ward admissions (35.26% from 51.67%) and more directed to operating theaters (29.83% from 16.85%), suggesting improved patient management (p < 0.018). CONCLUSION The study confirmed surgical skills training effectiveness in Tanzanian settings, highlighting TDTR's role in improving teamwork and healthcare processes that enhanced patient outcomes. To sustain progress and empower independent trauma educators, ongoing refresher sessions and expanding TDTR across low- and middle-income countries are recommended to align with global surgery goals.
通过创新的创伤和灾害团队应对培训加强创伤护理:坦桑尼亚的混合学习方法。
背景在坦桑尼亚,基础设施不足和创伤应对培训短缺加剧了与创伤相关的死亡事故。为应对这些挑战,麦吉尔大学全球外科中心开设了创伤与灾难团队应对课程(TDTR)。本研究评估了基于模拟的 TDTR 培训对护理人员的知识/技能和医疗流程的影响,以提高患者的治疗效果。TDTR 由坦桑尼亚 Muhimbili 骨科研究所的讲师于 2023 年 8 月 16 日至 18 日主持,22 名参与者参加了模拟技能课程的在线和面对面混合培训。经过验证的工具在干预前后对参与者的知识/技能和团队合作进行了评估,同时还进行了反馈调查。结果参与者的自我评估技能显著提高(中位数从 34 提高到 58,p < 0.001),团队合作能力也显著提高(中位数从 44.5 提高到 87.5,p < 0.003)。99% 的参与者对 TDTR 达到他们的期望表示满意,97% 的参与者对今后的教学课程感兴趣。干预后 6 个月的到达护理时间从 29 分钟大幅减少到 13 分钟,改善了 55.17%(p < 0.004)。干预后,病房收治率降低(从 51.67% 降至 35.26%),更多患者被送往手术室(从 16.85% 降至 29.83%),这表明患者管理得到了改善(p < 0.018)。为了保持进展并增强独立创伤教育者的能力,建议持续开展进修课程并在中低收入国家推广 TDTR,以与全球外科目标保持一致。
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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