心肺复苏实时反馈装置连同反思实践培训模式在医院非医务工作者心肺复苏技能培训中的应用
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摘要
[目的]观察心肺复苏实时反馈装置+反思实践的培训模式在医院非医务工作者心肺复苏技能培训中的应用效果。[方法]采用随机对照的研究方法,按培训方式不同,将126名医院非医务工作者分为三组:A组为情景模拟演练培训组(n=41),B组为情景模拟演练+反思实践培训组(n=40),C组为情景模拟演练+实时反馈装置+反思实践培训组(n=45)。培训后将反馈装置调为导师考核模式,对三组成员进行考核,对比三组技能考核成绩和质量监测结果。[结果]培训后,A组、B组、C组三组复苏技能考核成绩合格率分别为75.6%(31人)、87.5%(35人)、100%(45人),差异有统计学意义(P <0.05)。培训后,20个考核分项目得分在三组间比较,有7个分项目得分差异有统计学意义(P <0.05),A组得分均最低,而C组在平均按压频率、平均按压深度两项中得分高于B组,以上差异均有统计学意义(P <0.05)。培训后,三组学员平均按压频率、平均按压深度、滞留次数(胸廓回弹)、平均通气量4个质量反馈监测数据差异有统计学意义(P <0.05),C组在平均按压频率、平均按压深度、滞留次数(胸廓回弹)三方面数据最佳。三组学员按压频率与按压深度呈负相关(r=-0.799,P <0.01),按压频率与滞留次数呈正相关(r=0.873,P <0.01)。[结论]心肺复苏实时反馈装置+反思实践的培训模式能优化医院非医务工作者心肺复苏技能培训的部分环节,提高培训的整体质量,值得进一步推广和实施。
引文
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[18]杜贤进,魏捷,吕菁君,等.心肺复苏实时反馈系统在心肺复苏培训中应用的效果研究[J].临床急诊杂志,2016(7):542-545.
[19]龚峥,赵燊,李燕春,等.心肺复苏反馈装置对复苏按压质量考核的影响[J].中华急诊医学杂志,2018(2):183-187.
[20]MEH O,PERKINS G D,CARIOU A.Out-of-hospital cardiac arrest:prehospital management[J].Lancet,2018,391(10124):980-988.
[21]DAVIS D P,GRAHAM P G,HUSA R D,et al.A performance improvement-based resuscitation programme reduces arrest incidence and increases survival from in-hospital cardiac arrest[J].Resuscitation,2015,92:63-69.
[23]ZHA Y,ARIYO M,OLANIRAN O,et al.Cardiopulmonary resuscitation capacity in referral hospitals in nigeria:understanding the global health disparity in Resuscitation Medicine[J].J Natl Med Assoc,2018,110(4):407-413.
[2]王立祥,孟庆义,余涛,等.中国心肺复苏培训教程[D].北京:中华医学会与中国研究型医院,2017.
[3]HASSELQVIST-AX I,RIVA G,HERLITZ J,et al.Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest[J].New E J M,2015,372(24):2307-2315.
[4]余涛,刘亚华.中国心肺复苏培训破冰启航---中国心肺复苏培训导师班纪实[J].中华灾害救援医学,2017,5(8):478.
[5]NEUMAR R W,SHUSTER M,CALLAWAY C W,et al.Part 1:executive summary:2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care[J].Circulation,2015,132(18):S 315-367.
[6]ISERBYT P,BYRA M.The design of instructional tools affects secondary school students’learning of cardiopulmonary resuscitation(CPR)in reciprocal peer learning:a randomized controlled trial[J].Resuscitation,2013,84(11):1591-1595.
[7]SULLIVAN N J,DUVAL-ARNOULD J,TWILLEY M,et al.Simulation exercise to improve retention of cardiopulmonary resuscitation priorities for in-hospital cardiac arrests:a randomized controlled trial[J].Resuscitation,2015,86:6-13.
[8]REDMOND B.Reflection in action:developing reflective practice in health and social services[M].London:Routledge,2017.
[9]陶秀萍.社区医务人员徒手心肺复苏术培训的效果[J].中华灾害救援医学,2017,5(6):318-332.
[10]杨石,何文锦,刘凡.中医院心肺复苏培训和实践中的误区及对策探讨[J].中国中医急症,2017,26(7):1207-1210.
[11]HAZINSKI M F.Measured progress in cardiopulmonary resuscitation[J].Circulation,2016,134(25):2043-2045.
[12]ABELLA B S,ALVARADO J P,MYKLEBUST H,et al.Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest[J].JAMA,2005,293(3):305-310.
[13]GYLLENBORG T,GRANFELDT A,LIPPERT F,et al.Quality of bystander cardiopulmonary resuscitation during real-life out-of-hospital cardiac arrest[J].Resuscitation,2017,120:63-70.
[14]KLEINMAN M E,BRENNAN E E,GOLDBERGER Z D,et al.Part 5:adult basic life support and cardiopulmonary resuscitation quality:2015American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care[J].Circulation,2015,132(18):S414-S435.
[15]HELLEVUO H,SAINIO M,NEVALAINEN R,et al.Deeper chest compression:more complications for cardiac arrest patients?[J].Resuscitation,2013,84(6):760-765.
[16]IDRIS A H,GUFFEY D,PEPE P E,et al.Chest compression rates and survival following out-of-hospital cardiac arrest[J].Crit Care Med,2015,43(4):840-848.
[17]HAFNER J W,JOU A C,WANG H,et al.Death before disco:the effectiveness of a musical metronome in layperson cardiopulmonary resuscitation training[J].J Emerg Med,2015,48(1):43-52.
[18]杜贤进,魏捷,吕菁君,等.心肺复苏实时反馈系统在心肺复苏培训中应用的效果研究[J].临床急诊杂志,2016(7):542-545.
[19]龚峥,赵燊,李燕春,等.心肺复苏反馈装置对复苏按压质量考核的影响[J].中华急诊医学杂志,2018(2):183-187.
[20]MEH O,PERKINS G D,CARIOU A.Out-of-hospital cardiac arrest:prehospital management[J].Lancet,2018,391(10124):980-988.
[21]DAVIS D P,GRAHAM P G,HUSA R D,et al.A performance improvement-based resuscitation programme reduces arrest incidence and increases survival from in-hospital cardiac arrest[J].Resuscitation,2015,92:63-69.
[23]ZHA Y,ARIYO M,OLANIRAN O,et al.Cardiopulmonary resuscitation capacity in referral hospitals in nigeria:understanding the global health disparity in Resuscitation Medicine[J].J Natl Med Assoc,2018,110(4):407-413.