开发和测试疑似或确诊新冠肺炎患者心肺复苏管理方案:现场模拟研究

JMIR nursing Pub Date : 2022-03-16 DOI:10.2196/38044
A. Sowan, J. Heins, Christopher S. Dayton, Elizabeth Scherer, W. Tam, H. Saikumar
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引用次数: 0

摘要

背景对疑似或确诊新冠肺炎的患者进行复苏给组织和蓝色代码团队带来了独特的挑战。应用美国心脏协会(AHA)新冠肺炎相关临时复苏指南和类似欧洲指南的研究很少。目的本研究旨在开发和测试基于AHA新冠肺炎相关临时复苏指南的心肺复苏方案。方法在医疗重症监护室进行现场模拟研究。新冠肺炎心肺复苏方案由11名医护团队成员创建和验证,并使用4次模拟会议进行测试,其中46名蓝色代码团队成员参与。在模拟过程中,我们观察到角色的明确性、沟通的有效性、团队动态、感染控制措施以及基本用品和设备的可用性。结果向蓝色代码团队汇报了每次模拟会议中发现的主要问题,并用于进一步修订协议。其中包括任务分配、设备和用品的可用性,以及室内和室外团队之间的沟通失败。解决方案包括改变团队成员的位置、角色和责任;创建隔离码药物包、呼吸治疗试剂盒和隔离码蓝色袋子;以及使用双向无线电和带护目镜的N-95口罩,以加强团队之间的沟通。结论本研究阐明了实施AHA新冠肺炎相关临时复苏指南的挑战。现场模拟是快速培训、识别不可靠设备和无效低效工作流程以及管理物理环境复杂性的有效方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Developing and Testing a Protocol for Managing Cardiopulmonary Resuscitation of Patients with Suspected or Confirmed COVID-19: In Situ Simulation Study
Background Resuscitating patients with suspected or confirmed COVID-19 imposes unique challenges to organizations and code blue teams. Studies that applied the American Heart Association (AHA) COVID-19–related Interim Resuscitation Guideline and similar European guidelines are scarce. Objective This study aimed to develop and test a cardiopulmonary resuscitation protocol based on the AHA COVID-19–related Interim Resuscitation Guideline. Methods The study was conducted as an in situ simulation in a medical intensive care unit. The COVID-19 cardiopulmonary resuscitation protocol was created and validated by 11 health care team members and tested using 4 simulation sessions where 46 code blue team members participated. During the simulation, we observed role clarity, the effectiveness of communication, team dynamics, infection control measures, and the availability of essential supplies and equipment. Results The main issues identified in each simulation session were debriefed to the code blue teams and used to further revise the protocol. These include the assignment of tasks, availability of equipment and supplies, and failure of communication between the in-room and out-of-room teams. Solutions included changes in the placement of team members and roles and responsibilities; the creation of an isolation code medication package, a respiratory therapy kit, and an isolation code blue bag; and the use of two-way radios and N-95 masks with eye goggles to enhance communication between the teams. Conclusions This study shed light on the challenges to implement the AHA COVID-19–related Interim Resuscitation Guideline. The in situ simulation was an effective approach for rapid training, identifying unreliable equipment and ineffective and inefficient workflow, and managing the complexity of the physical environment.
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CiteScore
5.20
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