内科理论与实践

内科理论与实践 ›› 2024, Vol. 19 ›› Issue (01): 63-67.doi: 10.16138/j.1673-6087.2024.01.11

• 论著 • 上一篇    下一篇

PDCA结合情景模拟的培训模式对提高门诊急救质量的研究

邓雪芹, 陈瑜, 陈帅军, 包璇()   

  1. 上海交通大学医学院附属瑞金医院门诊部，上海 200025
  • 收稿日期:2023-06-05 出版日期:2024-02-29 发布日期:2024-04-28
  • 通讯作者: 包璇 E-mail:bx22354@rjh.com.cn

A study of training mode of PDCA circulation management combined with scenario-based simulation on improving first-aid quality in outpatient

DENG Xueqin, CHEN Yu, CHEN Shuaijun, BAO Xuan()   

  1. Department of Outpatient, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-06-05 Online:2024-02-29 Published:2024-04-28
  • Contact: BAO Xuan E-mail:bx22354@rjh.com.cn

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摘要：

目的: 探讨PDCA循环管理结合情景模拟的培训模式对提高门诊突发事件急救质量的效果。方法: 将2021年1月至2022年12月上海交通大学医学院附属瑞金医院北部院区门诊护士经筛选后共38名作为研究对象，其中男性1名，女性37名，平均年龄（29.89±5.62）岁。此外选取同一时期门诊突发急救事件共71例患者作为研究对象，进行回顾性分析。2022年1月前采用常规模式下的急救培训设为实施前，2022年1月后采用PDCA结合情景模拟模式（新模式）下的急救培训设为实施后，比较实施前后门诊护士急救能力（理论考试、基本操作考试、综合急救能力考试）、急救病例中的急救表现（启动时间、转运时间、急救成功率、纠纷及投诉率、满意度评分）以及自我效能感（一般自我效能量表评分）。结果: 经过不同模式培训后，实施后护士急救能力中的理论考试[（89.19±6.50）分比 （85.11±6.84）分]、综合急救能力考试[（87.76±6.10）分比（84.38±5.19）分]及基本操作各项技能考试成绩均优于实施前（均P<0.001）；在真实急救病例中，实施后启动时间[（4.89±1.24） min比（5.56±1.19） min]、转运时间[（9.36±1.05） min比（10.24±1.26） min]、纠纷及投诉率（2.8%比17.1%）及满意度评分[（87.14±9.68）分比（81.63±11.18）分]也显著优于实施前（均P<0.05）；实施后护士一般自我效能量表总评分也较实施前明显提高[（2.53±0.24）分比（2.31±0.22）分，P<0.05]。结论: 采用PDCA循环管理结合情景模拟模式下的急救培训可有效提升门诊护士的急救能力和自我效能感，减少其紧张焦虑情绪，并在真实突发事件中提高急救质量，急救表现更好。

关键词: PDCA循环管理, 情景模拟, 急救培训, 突发事件, 急救质量

Abstract:

Objective To evaluate the effect of training mode combing Plan-Do-Check-Act (PDCA) circulation management with scenario-based simulation on first-aid quality in outpatient emergency incidents. Methods From January in 2021 to December in 2022, the outpatient nurses in Ruijin Hospital (North Branch) affiliated to Shanghai Jiao Tong University School of Medicine were selected and total 38 nurses with an of average age [(29.89±5.62) years] enrolled in the study, including 1 male and 37 females. In the same period, a total of 71 outpatient emergency incidents were selected as the research objects. All collected information was done retrospective analysis. The nurses were divided into two groups. Before January in 2022, the nurses received the first-aid training of routine mode were enrolled in pre-implementation group. After January in 2022, the nurses trained through the first-aid training of PDCA circulation management combined with scenario-based simulation (new mode) were enrolled in post-implementation group. The two groups were compared in terms of first-aid ability (theory test, basic operation examination, comprehensive first-aid ability examination), first-aid performance (start-up time, transport time, first-aid success rate, disputes/complaints rate, satisfaction score) in real emergency incidents, and self-efficacy (scores of general self-efficacy scale). Results Following the first-aid training, the post-implementation group’s scores in theory test (89.19±6.50 vs 85.11±6.84) and comprehensive first-aid ability examination (87.76±6.10 vs 84.38±5.19) as well as scores in various items of basic operation examination were significantly higher than those in pre-implementation group (P<0.001). Meanwhile, the first-aid performance in the post-implementation group showed significantly shorter start-up time [(4.89±1.24) min vs (5.56±1.19) min] and transporting time [(9.36±1.05) min vs (10.24±1.26) min], lower dispute/complaint rate (2.8% vs 17.1%) and higher satisfaction score (87.14±9.68 vs 85.11±6.84) than those in the pre-implementation group in real emergency incidents (P<0.05). In addition, the post-implementation group’s overall scores of general self-efficacy scale increased remarkably than that in the pre-implementation group (2.53±0.24 vs 2.31±0.22, P<0.05). Conclusions The first-aid training combining PDCA circulation management with scenario-based simulation can effectively enhance outpatient nurses’ first-aid ability and self-efficacy, reduce their stress and anxiety, and make them improve first-aid quality and achieve better performance in real emergency incidents.

Key words: PDCA circulation management, Scenario-based simulation, First-aid training, Emergency incident, First-aid quality

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