利用运输监控和通信应用提高设施间运输过程中的态势感知：基于模拟的试点研究。

IF 1.7 3区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of Patient Safety Pub Date : 2025-10-01 Epub Date: 2025-08-08 DOI:10.1097/PTS.0000000000001402

Matthew Cook, Rachel Umoren, Elizabeth Steinlage, Prashanth Rajivan, Lun Li, John Feltner, Andia Pouresfandiary Cham, Taylor Sawyer

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Situational awareness (perception, the recognition of the patient's status; comprehension, the understanding of the significance of patient's status; and projection, anticipation of what the patient's status will likely become) and the overall duration of communication was measured and compared between and within groups.Results: Thirty-three subjects (20 MCP, 13 PCCT) participated in 52 simulations. MCPs had higher overall situational awareness scores with use of the T-MAC app compared with ad hoc phone calls with increased mean perception (98%, T-MAC versus 79%, no T-MAC, P = 0.003) and projection (53%, T-MAC versus 40%, no T-MAC, P = 0.004) scores before a patient event (sudden adverse change to patient status); and increased perception (83%, T-MAC versus 64%, no T-MAC, P = 0.03); comprehension (68%, T-MAC versus 48%, no T-MAC, P = 0.04); and projection (58%, T-MAC versus 30%, no T-MAC, P = 0001) scores after the event. 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引用次数: 0

摘要

目的：评估使用模拟远程运输应用程序与医疗控制医生（MCP）和运输团队之间临时电话呼叫对新生儿设施间运输过程中态势感知和沟通的影响。方法：在这项试点研究中，mcp和儿科重症监护运输小组（PCCT）参与了模拟新生儿运输，有或没有模拟运输监测和通信（T-MAC）应用。情境感知（感知，对患者状态的识别；理解，对患者状态重要性的理解；预测，对患者状态可能会变成什么样的预期）和总体沟通持续时间被测量并在组间和组内进行比较。结果：33名受试者（20名MCP， 13名PCCT）参加了52次模拟。与临时电话相比，使用T-MAC应用程序的mcp具有更高的总体态势感知得分，在患者事件（患者状态的突然不利变化）之前，平均感知（98%，T-MAC对79%，无T-MAC， P = 0.003）和预测（53%，T-MAC对40%，无T-MAC， P = 0.004）得分增加；提高了认知（83%，麦迪vs 64%，没有麦迪，P = 0.03）；理解能力（68%，麦迪vs 48%，没有麦迪，P = 0.04）；和预测得分（58%，麦迪vs 30%，没有麦迪，P = 0001）。PCCTs在事件发生前的平均感知得分（98%,T-MAC vs 81%, P = 0.02）和预测得分（54%,T-MAC vs 45%，没有T-MAC）更高。不良事件的呼叫时间中位数减少（125，IQR: 45秒，T-MAC vs 140， IQR: 70秒，无T-MAC， P = 0.046）。结论：在这种模拟环境中，使用专门设计的新生儿设施间运输远程运输应用程序可以提高态势感知能力，提高运输团队利益相关者的沟通效率。提高mcp的态势感知比提高PCCT成员的态势感知有更大的好处。T-MAC应用程序的开发和使用需要进一步的调查。

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Improving Situational Awareness During Interfacility Transport Using a Transport Monitoring and Communication Application: A Simulation-Based Pilot Study.

Objectives: To evaluate the impact of using a simulated teletransport application compared with ad hoc phone calls between medical control physicians (MCP) and transport teams on situational awareness and communication during neonatal interfacility transports.

Methods: In this pilot study, MCPs and pediatric critical care transport teams (PCCT) participated in simulated neonatal transports with or without a simulated transport monitoring and communication (T-MAC) application. Situational awareness (perception, the recognition of the patient's status; comprehension, the understanding of the significance of patient's status; and projection, anticipation of what the patient's status will likely become) and the overall duration of communication was measured and compared between and within groups.

Results: Thirty-three subjects (20 MCP, 13 PCCT) participated in 52 simulations. MCPs had higher overall situational awareness scores with use of the T-MAC app compared with ad hoc phone calls with increased mean perception (98%, T-MAC versus 79%, no T-MAC, P = 0.003) and projection (53%, T-MAC versus 40%, no T-MAC, P = 0.004) scores before a patient event (sudden adverse change to patient status); and increased perception (83%, T-MAC versus 64%, no T-MAC, P = 0.03); comprehension (68%, T-MAC versus 48%, no T-MAC, P = 0.04); and projection (58%, T-MAC versus 30%, no T-MAC, P = 0001) scores after the event. PCCTs had higher mean perception (98%, T-MAC versus 81%, no T-MAC, P = 0.02) and projection (54%, T-MAC versus 45% no T-MAC) scores before the event. The median duration of call times decreased for adverse events (125, IQR: 45s, T-MAC versus 140, IQR: 70s, no T-MAC, P = 0.046).

Conclusions: In this simulated setting, the use of a specially designed teletransport app for neonatal interfacility transports improved situational awareness and increased the efficiency of communication for transport team stakeholders. There was greater benefit in improving situational awareness for the MCPs than for PCCT members. The development and use of a T-MAC application warrants further investigation.

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来源期刊

Journal of Patient Safety HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.60

自引率

13.60%

发文量

302

期刊介绍： Journal of Patient Safety (ISSN 1549-8417; online ISSN 1549-8425) is dedicated to presenting research advances and field applications in every area of patient safety. While Journal of Patient Safety has a research emphasis, it also publishes articles describing near-miss opportunities, system modifications that are barriers to error, and the impact of regulatory changes on healthcare delivery. This mix of research and real-world findings makes Journal of Patient Safety a valuable resource across the breadth of health professions and from bench to bedside.